Oral
Answers to
Questions

INTERNATIONAL TRADE

The Secretary of State was asked—

Trade Envoy Programme

Chris Davies: What recent assessment he has made of the effectiveness of the trade envoy programme.

Liam Fox: The Prime Minister’s trade envoys do a great job engaging with countries where trade and investment opportunities have been identified. Last year, trade envoys helped contribute to export wins of more than £15.5 billion in their markets. Based on an outlay of just under £250,000 for the programme over the same period, each trade envoy, on average, supported £700 million in exports.

Chris Davies: Does my right hon. Friend plan to appoint any further trade envoys beyond those already appointed?

Liam Fox: That is the least disguised job application that I have heard in some time. There are 30 trade envoys covering 60 markets around the world. The programme is reviewed regularly in consultation with our overseas team and any new suggestions are put to the Prime Minister. I will let my hon. Friend know as soon as possible if any vacancies occur.

Barry Sheerman: Before these trade envoys do anything else, will the Secretary of State bring them all together and allow them to have the same briefing from the CBI that many Members from all parties had this week? That CBI briefing on the impact of leaving the EU says that it will be a disaster for working men and women, industry and manufacturing up and down the country.

Liam Fox: As I often point out to the hon. Gentleman, the working men and women of his constituency had a very different view about the reasons for leaving the European Union. I make sure that our trade envoys get a much wider range of briefings than simply one—a highly suspect one in that case.

John Bercow: I call Mark Field—sorry, Mark Prisk. I beg your pardon.

Mark Prisk: As the Prime Minister’s trade envoy to Brazil, I have been immensely impressed by the UK companies already operating there, but frankly there are not enough of them. May I urge the Secretary of State to challenge business membership organisations, including the CBI, to ensure that they put exporting at the heart of their work?

John Bercow: There is more than one Field in the House, but there is only one Prisk.

Liam Fox: First, I pay tribute to the work that my hon. Friend has done. We have a growing and increasingly improving trade relationship with Brazil, but he is absolutely right that we require business to put exporting at its heart. The positive signs in recent times are that that is happening and we will export more than 30% of our GDP this year for the first time in a considerable while.

David Drew: What parliamentary scrutiny is there of this programme?

Liam Fox: There is cross-party ability to look at the programme. We have an International Trade Committee and questions in this House, and I have just reported to the House the value that we think the programme has.

Jeremy Lefroy: As trade envoy to Ethiopia, last week I had a meeting at the African Union about the continental free trade area agreement, which is incredibly important for the future of all countries in Africa and for the United Kingdom. Does my right hon. Friend see roles for the trade envoy programme in engaging with these free trade areas, which cover more than one country?

Liam Fox: I would hope that our trade envoys, along with our posts in those various African countries, would understand the value that increased intra-African trade can bring both to those countries and in increased opportunities for UK exporters.

Exiting the EU: Trade Agreements

Catherine West: What estimate his Department has made of the number of new institutions required to replicate the terms of existing trade agreements with the EU after the UK leaves the EU.

Greg Hands: The Government are committed to seeking continuity in our trading arrangements to minimise disruption to businesses, consumers and our trading partners. We will ensure that the institutional provisions of existing agreements are met as the UK begins to operate its independent trade policy.

Catherine West: What parliamentary shared goals do the Government have in mind for the new arrangements that will come into place?

Greg Hands: To be absolutely clear, if the hon. Lady is referring to the Trade Bill, what we are looking at is the transitioning of existing trading arrangements with the EU. All those agreements have already been through parliamentary scrutiny. If she is referring to future trade agreements, we will bring that subject back to this House in due course.

Julia Lopez: One of the new institutions we shall need to set up as we leave the EU is a trade remedies authority. I recently travelled to Canada and the US with the International Trade Committee. They are two countries that have robust trade remedies authorities whose impartiality can be critical in reaching economically sound judgments. What assurances can the Minister offer the House that the UK Government are similarly committed to an independent TRA that will be free from undue political interference?

Greg Hands: I congratulate my hon. Friend and the other members of the Committee on their recent visit to the United States and Canada. Those are two of the countries whose trade remedy systems we have studied, along with Australia and, in fact, the European Union system itself. As my hon. Friend says, it is common, although not universal, for the investigation process to be independent of Government, but there is still a political decision at the end of the process by a Minister who is accountable to Parliament. It is worth pointing out, by the way, that all the Opposition parties voted against the creation of the trade remedies authority in the first place.

Patrick Grady: I do not know whether a bridge counts as an institution, but I wonder whether the policy of the Department for International Trade, like that of the Foreign Office, is that a new fixed link between Britain and France is required to continue to improve trade after Brexit.

Greg Hands: We have been absolutely clear throughout this process about the importance of maintaining our trading relations with the European Union. That is why we are seeking to ensure that trade is as frictionless as possible, and why we are seeking a comprehensive free trade agreement with the EU.

Philip Hollobone: The EU does not have comprehensive free trade agreements with some of the world’s major economies. Does the Minister believe that the United Kingdom is likely to strike such deals more quickly than the European Union?

Greg Hands: We remain supportive of the European Union’s negotiations with some of those trade partners while we are still a member of the EU, because we are strong believers in free trade. We have also set up 14 trade working groups with many of the leading economies, including China, India and the United States, and we look forward to making further progress with those arrangements in due course.

Judith Cummins: Our current trading relationships with many partners ranging from Switzerland to Mexico are overseen by joint committees of the EU and those other states. Will the Minister tell  us how many of the committees will be replaced by UK equivalents after Brexit, and what progress his Department has made in establishing those institutions? Will he also tell us where the staff and expertise will be sourced from, and at what cost to the taxpayer?

Greg Hands: Let me say first that the UK played a leading role in establishing the European Union arrangements with countries such as Mexico and Switzerland in the first place. As for the question of where we go from here, our priority is to maintain continuity in our trading relations, ensuring that all the 40-plus trading agreements we have with 70-plus countries become UK arrangements as we leave the European Union. The precise format of the further discussions that we will have with those partners will be a matter for future arrangements.

Exiting the EU: Trade Agreements

Ruth Cadbury: Whether he plans to replicate the terms of EU free trade agreements in trade deals with Switzerland, Norway and Turkey after the UK has left the EU; and if he will make a statement.

Liam Fox: As we leave the EU, the Government intend as far as possible to maintain the effects of existing EU free trade agreements and other EU preferential arrangements. That includes agreements with Switzerland, Norway and Turkey.

Ruth Cadbury: I am going to pursue the questions asked by my hon. Friends the Members for Hornsey and Wood Green (Catherine West) and for Bradford South (Judith Cummins), which the Minister for Trade Policy did not answer. In 2016, the Secretary of State told the International Trade Committee that he would prioritise securing an agreement with Switzerland. The current relationship between the EU and Switzerland is overseen by some 20 joint committees. Very specifically, how many of those committees will be replaced by UK-Swiss committees, and how far along in the process of setting up those institutions is his Department?

Liam Fox: I met Swiss Ministers in Geneva recently, and we discussed what the future arrangement would be. Clearly, how we oversee the arrangement depends on what the arrangement itself is, and that is currently under negotiation.

Desmond Swayne: We do not need trade agreements to trade, do we?

Liam Fox: No.

Bill Esterson: The Secretary of State has told us that he plans to replicate all the provisions of the trade agreements that the UK has, as a member of the EU, with Norway, Switzerland and Turkey. Those provisions include free movement of people in the cases of Norway and Switzerland, and a customs union with Turkey. Will the Secretary of State confirm that it is the Government’s policy to replicate all of them?

Liam Fox: In our transitional arrangements, we have made very clear that the key element is continuity. Until we create bespoke arrangements with those countries, we will maintain the provisions that exist today.

UK Trading Relations: Pacific Countries

Colin Clark: What steps he is taking to strengthen UK trading relations with Australia, New Zealand and other Commonwealth countries in the Pacific.

Greg Hands: We have the opportunity to enhance our global trading relationships, including those with the countries with which we share bonds of history and friendship. My right hon. Friend the Secretary of State travelled to Australia and New Zealand in November to promote free trade and deepen those trading relationships. The April Commonwealth summit here in London will provide an opportunity for us to continue that work with all member states.

Colin Clark: Has my right hon. Friend considered how UK agriculture will compete with our Commonwealth cousins when we agree a free trade deal after leaving the customs union?

Greg Hands: I praise my hon. Friend for his distinguished business career in the sector before coming to this House; it means he brings real expertise to the House. He will know that we have established trade working groups with both Australia and New Zealand to explore possibilities in trade and investment. They will include agriculture, but it is too early to be sure how it will be covered in those and other future trading arrangements. The New Zealanders are very interested in this—the New Zealand High Commission recently wrote to the International Trade Committee saying:
“Given the complementarity of our two economies and our deep bilateral ties,”
they want to do something with us, and we very much agree.

Chris Elmore: On negotiations with New Zealand, the Minister will be aware that Wales has a large lamb industry—it is one of the great prides of the United Kingdom—so can he give an absolute assurance that in his negotiations with New Zealand he will not put any Welsh farms and the Welsh lamb industry at risk?

Greg Hands: I am keenly aware, as are my right hon. Friend the Secretaries of State for International Trade and for Environment, Food and Rural Affairs, of the importance of British agriculture in all parts of the United Kingdom and of making sure we have the necessary protections in place on animal welfare standards and so on, and also of promoting the opportunity to export our excellent British goods. Food and drink is one of our fastest-growing export sectors, and we want people to take advantage of opportunities across the UK.

Gregory Campbell: What importance does the Minister attach to deepening and broadening our trade relationships with countries such as India, which has a widening middle class among its population of 1.25 billion?

Greg Hands: The Prime Minister’s first bilateral trade visit in November 2016 was to India, accompanied by the Secretary of State and myself. We have recently completed a trade audit with India that looks at all the barriers. India is at times a difficult market for British exporters to crack. We have a lot of advantages in doing business there, and the trade audit and the joint economic trade committee talks led by the Secretary of State last month are taking us in the right direction.

Exiting the EU: UK Trade

Joanna Cherry: What recent assessment he has made of the effect on UK trade of the UK leaving the EU single market and the Customs Union.

Liam Fox: By leaving the customs union and establishing a new ambitious arrangement with the EU, we will be seeking to maintain as frictionless as possible trade in goods between the UK and the EU, and the freedom to forge trade relations with partners around the world.

Joanna Cherry: The Norwegians have a saying: “Nothing is in as much of a hurry as a dead fish on the back of a lorry.” Like Norway, Scotland exports most of the fish it catches to the EU, which is why Norway has chosen to be a member of the single market, in particular to avoid non-tariff barriers so the fish can cross borders quickly. What assessment has the Secretary of State made of the impact of leaving the single market on the Scottish fishing industry?

Liam Fox: Of course, the majority of Scotland’s exports go to the rest of the UK, not the EU. The hon. and learned Lady talks about the value of the single market; it is just worth pointing out that, despite our membership of the single market, we have had a growing trade deficit with the EU at a time when we have had a growing trade surplus with the rest of the world. We want to establish the conditions for all our exports from all parts of the UK to be able to access the growing markets of the world, and, as the International Monetary Fund has pointed out, 90% of global growth in the next 10 to 15 years will be outside Europe.

Nick Smith: What is the Secretary of State’s preferred method of ensuring frictionless trade between the Republic and the north of Ireland?

Liam Fox: Our preferred option is to do that through a widespread and liberal agreement in trade with the European Union, as set out in the Government’s memorandum in December.

GREAT Festival of Innovation

Alan Mak: What progress he has made on arrangements for the GREAT Festival of Innovation in Hong Kong planned for March 2018.

Liam Fox: The GREAT festival will be held in Hong Kong from 21 to  24 March 2018. With more than 70 confirmed speakers, the festival will showcase the best of British innovation, the potential of the UK economy, and the strength of our world-class service sector.

Alan Mak: Britain is becoming a world leader in artificial intelligence, big data and the fourth industrial revolution technologies that will power future export growth. Will my right hon. Friend ensure that those technologies will be widely promoted at next month’s festival?

Liam Fox: They will indeed be widely represented. For example, UtterBerry, an AI-based infrastructure monitoring technology that has been used in this country in projects such as the Thames tideway and Crossrail, will be showcased. The festival will be an opportunity for us to show off the best of British innovation in general.

Overseas Direct Investment

Gillian Keegan: What progress he has made on his Department’s overseas direct investment strategy.

Graham Stuart: We are making great progress on supporting UK businesses to invest overseas, as this can have a substantial positive effect on the UK economy. The Department for International Trade has developed a suite of products and services that address market failures, to support British businesses.

Gillian Keegan: What update can the Minister provide on his Department’s overseas direct investment pilots? Will he also explain what opportunities ODI offers to British businesses?

Graham Stuart: My Department’s ODI support pilots have successfully demonstrated the impact that the Government can have in supporting UK businesses to overcome barriers to market access and to expand overseas. By harnessing the private sector wherever possible and focusing Government interventions only on market failures, my Department has successfully supported overseas investment for a range of UK businesses in six global markets.

Trade Deficit: Goods and Services

John Hayes: What recent estimate he has made of the UK’s trade deficit in goods and services.

Greg Hands: In 2016, the UK had a trade deficit with the EU of £70.97 billion, and a trade surplus of £39 billion with non-EU countries, up from £33.6 billion in 2015. The latest trade figures show that in 2017, the UK’s trade deficit in goods and services narrowed by £7 billion to £33.7 billion.

John Hayes: Balance of trade figures were once regarded as pivotal. They were even thought to win or lose elections. Given that we are now going to escape from the constraining clutches of the European Union, will my right hon. Friend invest again in old friends and rejuvenate our relationships in the realm with allies  such as Australia and New Zealand? What steps has he taken to ensure preferential arrangements with such old allies?

Greg Hands: My right hon. Friend asks a very good question. First, I should like to put on record my thanks to him for leading various Government trade delegations in recent years, including one to Colombia. I know that he takes a strong interest in this subject. As I said earlier, we have set up trade working groups with Canada, the United States, Australia and New Zealand, and, unlike the Opposition Front Benchers, we also voted for the comprehensive economic and trade agreement, the EU’s free trade agreement with Canada. The Secretary of State has been in all four of those markets in the past year, leading efforts to break down trade barriers and to seek new trade agreements.

John Bercow: I am sure that the right hon. Member for South Holland and The Deepings (Mr Hayes) enjoyed going to Colombia. Quite what Colombia made of the right hon. Gentleman is not recorded.

Thangam Debbonaire: The creative sector in Bristol West—particularly the music industry—is important, and trade in that sector is a service industry. What steps are the Government taking to ensure that the creative industries, particularly the music industry, are supported as we leave the EU?

Greg Hands: The hon. Lady is quite right to point out the importance of services to our trade. Overall, services represent 80% of our economy and 79% of jobs. My right hon. Friend the Secretary of State and the whole team are working closely with the Department for Digital, Culture, Media and Sport to ensure that we continue to grow exports from our creative sector and that investment from abroad continues to come into the sector. We often visit places such as Tech City UK and techUK, and we are working closely with them to ensure that we have a flourishing future for our creative industries.

Martin Vickers: Last week, as co-chair of the all-party parliamentary group on Kosovo, I visited a British company in Pristina that has a £20 million investment there. What opportunities does the Minister foresee for widening our trade in goods and services with Kosovo and the neighbouring western Balkan countries?

Greg Hands: This is a very good opportunity. That is a part of the world that I know well, and I think that the company to which my hon. Friend refers is called Fox Marble—a highly appropriate name for this particular Question Time. It finds top-quality marble in Kosovo for export, and it should be congratulated. In regard to the wider region, we work closely with the Foreign and Commonwealth Office to promote trading opportunities throughout the region.

Topical Questions

Rehman Chishti: If he will make a statement on his departmental responsibilities.

Liam Fox: My Department has responsibility for export promotion, foreign and outward direct investment, and trade policy. I am delighted to inform the House that my Department has appointed the first three of our network of Her Majesty’s trade commissioners, and Richard Burn, Antony Phillipson and Crispin Simon will serve as trade commissioners for China, North America and south Asia respectively. They will develop and deliver strategies to ensure that we can take full advantage of leaving the European Union, the single market and the customs union.

Rehman Chishti: I thank the Secretary of State for that answer. What evidence is he seeing for growth in UK manufacturing exports to the wider world? I have just returned from a visit to Pakistan with leading British companies in my role as trade envoy to enhance trading between our two great countries; will the Secretary of State join me in paying tribute to Elin Burns and Matt Lister, our trade experts in Pakistan?

Liam Fox: I pay tribute to all those people. We are seeing a big rise in our manufacturing order books, not least on the back of our strong export performance. In recent times, we have seen the biggest growth in consistent monthly manufacturing numbers for some 30 years. The figures produced by the Office for National Statistics suggest that our exports now represent 30.3% of our exported GDP—the second highest figure on record.

Barry Gardiner: Given the Government Front-Bench team’s uncharacteristic failure to welcome my hon. Friend the Member for Bradford South (Judith Cummins) to the Opposition Front Bench, I know that you would want me to do so, Mr Speaker.
Is the Secretary of State aware that the Food Standards Agency recently detained large quantities of out-of-date meat in a company called Norish Cold Storage? The meat is believed to have come from Ireland and South America. Given that Norish is the parent company of Town View Foods, one of the directors of which, Plunkett Matthews, was also a director of Freeza Meats, a company implicated in the Irish horsemeat scandal in 2013 and found guilty of meat-labelling fraud, will the Secretary of State urgently liaise with Ministers in the Republic of Ireland, the FSA here and the Food Safety Authority of Ireland to ensure the supply chain for this illegal meat is identified, that our sanitary and phytosanitary regulations are properly enforced and that those behind the illegal trade—

John Bercow: Order. I say to the hon. Gentleman that if the meat was previously hot, it would certainly be freezing cold by now.

Liam Fox: I was not aware of that particular allegation. This cross-Government issue is clearly not one entirely for my Department, but I will ensure that other Ministers are made aware of it.

Philip Davies: There is immense potential for growth in bilateral trade and investment between the UK and Israel after we leave the EU. Does the Minister share my hope for yet greater levels of trade with the start-up nation, and will he update the House on the progress being made by the UK-Israel trade working group?

Graham Stuart: Britain’s relationship with Israel is stronger than ever, with record levels of bilateral co-operation in trade, investment, science and technology. As my hon. Friend rightly says, the UK-Israel trade working group is making good progress in ensuring continuity in our trading relationships as we leave the EU.

Jim Shannon: Bearing in mind the upcoming Israel Apartheid Week in universities, of which a boycott of Israel and its products is a big component, will the Minister outline how he intends to enhance trade with Israel for our mutual benefit and offset that destructive campaign by the anti-Israel movement?

Graham Stuart: We strongly welcome our ties with Israel, as does the hon. Gentleman. As has just been said, the Department has established a joint trade working group, and we continue to liaise closely with the Israeli Government to strengthen trade, investment and other ties between this country and Israel.

Peter Heaton-Jones: Next Friday, I will be attending the COMBEbusiness event, which showcases the brilliant small and medium-sized enterprises in north Devon. What is the Department doing to attract international investment to those businesses, which form the bedrock of the south-west’s economy?

Graham Stuart: We work in collaboration with the Heart of the South West local enterprise partnership to attract foreign direct investment into Devon. More widely, the Department works with local enterprise partnerships and local authorities across the south-west to promote inward investment opportunities to foreign-owned companies. In 2016-17, DIT recorded 101 inward investment projects in the south-west, creating 3,402 new jobs.

Hannah Bardell: Although my party does not want to leave the single market or the customs union, a properly planned and managed transition period is always top of the agenda for businesses across Scotland, particularly in our thriving food and drink sector. Does the Secretary of State agree with his own Government that a sensible transition period is required, or is he sticking to his cliff-edge position, which will have a devastating impact for businesses across Scotland and the UK?

Liam Fox: We believe across Government that the simplest way to get to the position that we will be able to enjoy, of leaving the single market and the customs union, is via a transition period that is carefully planned and that gives predictability to business.

Several hon. Members: rose—

John Bercow: Single-sentence inquiries are now required.

Craig Tracey: Last week I visited the US as part of a cross-party delegation to discuss the future of financial services, and I was very encouraged by the positive response from a variety of stakeholders. What assessment has the Secretary of State made of the potential for a future UK trade deal with the US?

Liam Fox: We have four working groups with the United States at the present time, and at the last one we announced a UK-US small and medium-sized enterprise dialogue. My hon. Friend will be pleased to know that the first dialogue on SMEs will take place next month and will involve more than 100 businesses as part of a very constructive process.

Jamie Stone: Remoteness of location in the UK is no constraint on the success of some of our malt whisky distilleries in Scotland. Can I tempt the Secretary of State or his Ministers to come and visit Old Pulteney in Wick or Glenmorangie in Tain? Will they do everything to secure the future prosperity of the distilleries in my constituency?

Liam Fox: I already have several invitations to visit distilleries, and I intend to take a very close personal interest in this particular sector.

Edward Argar: Further to his earlier answer, does my right hon. Friend agree that the prospects for future trade with our close friend and economic partner India remain very bright?

Greg Hands: Yes, my hon. Friend is right. I mentioned the India trade audit that has just been published. The Secretary of State met his Indian counterpart, Minister Prabhu, during our Joint Economic and Trade Committee meetings in January, and they agreed that bilateral work will now explore addressing barriers in four recommended sectors: food and drink, life sciences, information technology and services.

Mohammad Yasin: The UK remains a major transit hub for illegal wildlife trafficking, and we rely on Border Force to prevent that trade. Will the Minister tell his colleagues in the Home Office to ditch their dangerous plan to replace Border Force staff with volunteers?

Greg Hands: Actually, this Government have made enormous efforts to stop wildlife trafficking. My right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs made it a major part of his visit to south-east Asia last week, and he made particular reference to the pangolin, which at the moment is the world’s most trafficked animal. This Government are leading global efforts in combating this horrendous trade.

Chris Philp: Does my right hon. Friend agree that free trade helps consumers by lowering prices and that free trade has been one of the biggest contributors to combating global poverty over the past 100 years? Will he embrace the opportunities created by Brexit to do free trade deals that will help consumers and British businesses?

Liam Fox: At the WTO this week I again made the case for free trade, and the UK is a global champion of free trade. We tend to discuss our trade in terms of producers, but we must always remember that free trade is an enormous benefit to consumers in lowering prices, improving choice and increasing quality. Free trade has also been the route by which we have taken more than 1 billion people on this planet out of abject poverty in the past generation, which we should celebrate.

Lloyd Russell-Moyle: With no prosecutions leading to convictions since 2011, with no register of arms brokers—as the USA, Canada, Germany and France have—and with the Government selling weapons and spy equipment to eight human rights abusers, how can the Government continue to claim that we have the strongest arms export regime in the world, or are they just not implementing the rules?

John Bercow: I do not know whether colleagues are aware of it, but they rather ruin their questions when they try to pack too much in. Topical questions are supposed to be brief. I understand the temptation—I used to feel it myself—but it ends up being a worse and a lesser question than something shorter and more pithy. It is such an obvious point that the hon. Gentleman must be extraordinarily clever not to be able to grasp it.

Graham Stuart: All export licence applications are considered on a case-by-case basis against the consolidated EU and national arms export licensing criteria, based on the most up-to-date information and analysis available. I would be happy to meet the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) to discuss these issues further.

Eddie Hughes: How can the many excellent manufacturing businesses in the Black country benefit when we leave the customs union?

Greg Hands: My hon. Friend is a fine and upstanding voice for the Black country. He will know that manufacturing experienced a 2.8% growth rate over the past year. Leaving the customs union provides an opportunity to enhance that growth, particularly as manufacturing exports outside the EU are growing  so fast.

WOMEN AND EQUALITIES

The Minister for Women and Equalities was asked—

Women’s Vote Centenary Fund

Paul Blomfield: How much of the centenary fund to celebrate women having the right to vote has been spent; and how much of that funding has been distributed to women's organisations.

Stephen Morgan: How much of the centenary fund to celebrate women having the right to vote has been spent; and how much of that funding has been distributed to women’s organisations.

Amber Rudd: The centenary fund has paid out about £2.5 million so far; £1.2 million was given to Bolton, Bristol, Leeds, Leicester, London, Manchester and Nottingham, which are working with women’s organisations to deliver their suffrage centenary programmes. We are also funding the first ever statue of a women in Parliament Square—it will be of Millicent Fawcett.

Paul Blomfield: I thank the Minister for her answer. She will know that the Sheffield Female Political Association, founded in February 1851, was the first women’s suffrage organisation in the UK. Will she therefore join me in supporting the bid prepared by women across the voluntary, arts and education sectors to the fund? Will she wish them well in their ambition  to use the centenary to encourage opportunities for civic engagement by women who feel disengaged and disempowered?

Amber Rudd: I thank the hon. Gentleman for his question. I am delighted to congratulate him and to welcome the women of Sheffield in their bid to the centenary fund. I hope it will do exactly as he says: encourage more women to engage in political life in general.

Stephen Morgan: Will the Minister confirm what level of support the Government or their contracted company are providing to smaller women’s groups to encourage them to take up this funding?

Amber Rudd: Yes, I am happy to tell the hon. Gentleman that we have a website that will set all that out. If he wants to go on it himself, it is womensvotecentenaryfund.co.uk . The bidding process is set out there. Two types of grants are available. The larger one is up to £125,000 and the smaller one starts at £2,000. I hope that will give him and his constituents the information they need to apply for the grants.

Philip Hollobone: Are we not in danger of rather missing the point that the best way to celebrate the centenary of women’s suffrage is to get more women to register and actually to vote when elections turn up?

Amber Rudd: My hon. Friend is right, in that it is imperative that more women participate in political life, both by voting and by participating in this place. I think we can do both things: we can celebrate the centenary and, in our celebrations, make that point repeatedly so that we get more women involved.

Exiting the EU: Equalities Policy

Chris Law: What assessment she has made of the effect on the Government’s policies on equality of the UK leaving the EU.

Suella Fernandes: The UK Government’s record on equalities is one of the best in the world, and leaving the EU will not change that. The equality Acts and equivalent legislation in Northern Ireland provide the cornerstone of equalities protections in the UK and in some places go much further than EU requirements, for example, in our world-leading approach to gender pay gap reporting. We do not need to be part of the EU to sustain our record in this area.

Chris Law: A recent study published in Social Policy and Society has found that the UK’s voting record in the EU has historically placed business interests over women’s rights. What steps are this Government taking to ensure that post-Brexit Britain will not place business interests above ensuring equality?

Suella Fernandes: This Government have a proud record of protecting and enhancing women’s rights, and that record of action predates our membership of the EU, as seen, for example, in the Equal Pay Act 1970. The EU’s own gender equality index places us sixth out of 28, and our gender pay gap reporting requirements and our public sector equality duty are world-leading initiatives that go beyond EU law in many ways.

Tom Pursglove: As on employment rights, the UK has a been right at the forefront of advancing equality across the world. Will the Minister confirm that that simply is not going to change?

Suella Fernandes: Yes, we have a proud record, history and tradition in the UK of supporting workers, protecting civil liberties and championing human rights. Leaving the EU will in no way affect that historical tradition, of which we can all be proud.

Workplace Sexual Harassment

Rachael Maskell: If the Government will bring forward legislative proposals to amend section 40 of the Equality Act 2010 to protect employees from sexual harassment by third parties in the workplace.

Victoria Atkins: The Equality Act 2010 provides protection from harassment for employees, whether committed by their employer, co-workers or a third party. The coalition Government repealed the third party harassment provisions in section 40 of the Equality Act because they were unnecessary and overcomplicated. Employers have a legal obligation to protect their workers, and may be liable if they fail to take reasonable steps to prevent harassment of workers by third parties.

Rachael Maskell: I refer to my entry in the Register of Members’ Financial Interests. Unite’s campaign “Not on the menu” in the hospitality sector, and its research with cabin crew showing that the majority experience sexual harassment, demonstrate emphatically why section 40 of the Equality Act 2010 is vital. Will the Minister commit to implementing it, but with intervention after one episode not three, and focus on a zero-tolerance approach to any form of sexual harassment in the workplace?

Victoria Atkins: I am most concerned to hear about those incidents of harassment, and the hon. Lady should be reassured that they are covered already by the Equality Act. The reason those provisions in section 40 were repealed was that, as she has identified, they required not one but three occasions of harassment, and we know that, in the three years those provisions were in place, they were used only once. We have tried to improve the law, and I would encourage her to encourage people to use it.

Maria Miller: It is really encouraging to hear my hon. Friend’s response, but does she not agree that it is not just about getting the law right? We have to get the remedies within the law right. We have to encourage anonymised reporting in the workplace. We must also make sure that the unethical  use of non-disclosure agreements does not work to stop people bringing forward claims of sexual harassment in the first place.

Victoria Atkins: I thank my right hon. Friend for her question. With her expertise on the Women and Equalities Committee, she knows only too well the challenge we have in advertising the rights that people have in the workplace. I am particularly concerned with non-disclosure agreements. We know that they can be used for lawful reasons—for example, to protect client confidentiality—but they cannot be used to shield employers from claims of harassment or discrimination, and any work that her Committee can do to help the Government in advertising that, I would very much welcome.

Jo Swinson: I know from my many battles in the coalition Government—some successful, some not—that the Conservatives’ obsession with deregulation often gets in the way of protecting vulnerable workers. It is that obsession, I say to the Minister, that is the real reason why the provisions in the Equality Act were repealed—I know because I was in the discussions at the time. Surely, in the light of the Presidents Club and all the other evidence that is now in the public domain, it is time to look again at the issue and, by all means, to improve on the original provisions, as suggested by the hon. Member for York Central (Rachael Maskell).

Victoria Atkins: I very much pay tribute to the hon. Lady for the work that she did as a Minister and that she continues to do now in the House. We of course keep this matter under review, but on the point I made about the section 40 amendments, general protection exists under the Act. However, we will continue to look at the evidence, and we are very, very clear: discrimination and harassment in the workplace is simply not on and is against the law.

Dawn Butler: We have to be very clear about this. Because the Government repealed section 40 of the Equality Act 2010, there is now no statutory protection over third party harassment. If the Government are committed to protecting women and girls, will they show this by either reinstating section 40 or, at the very least, introducing stronger legislation to ensure protection against third party harassment?

Victoria Atkins: I hesitate to correct the hon. Lady, but that is simply not true: there is a general protection against harassment in the workplace; it is in the 2010 statue—it is a general protection against harassment. Of course, if there are any instances that Members on both sides of the House have of particular types of harassment or discrimination, I and the Home Secretary will always be willing to listen. However, the Equality Act protects workers, the general protection is there and, what is more, it is better than the section 40 protections, because it does not require three occasions of harassment; it requires just one.

Period Poverty

Paul Williams: What steps the Government are taking to tackle period poverty.

Victoria Atkins: No girl or woman should be held back because of her gender or her background. This is why the Department for Digital, Culture, Media and Sport has identified period poverty as a priority for the tampon tax fund, which, in 2018 and 2019, totals £15 million. We have encouraged bids to address this issue.

Paul Williams: In Stockton South and across Teesside, residents led a “free period” campaign, which persuaded local authorities to provide free sanitary protection for women and girls living in poverty. Will the Minister meet me to work out how that might be replicated in other parts of the country?

Victoria Atkins: I am delighted to hear that Stockton-on-Tees Council has started that innovative project, and, in fairness to our Scottish colleagues, the same is happening in Aberdeen as well. I look forward very much to hearing the results of that pilot, and I would be happy to meet the hon. Gentleman to discuss them.

Karen Lee: I was pleased to hear that the student union in Lincoln sells sanitary products at cost before VAT. Will the Minister acknowledge that sanitary products are not a luxury, but a necessity? My question is: will she accelerate the timetable for removing the tampon tax—yes, or no?

Victoria Atkins: I am also glad that our county university is leading the way on this, but the hon. Lady knows that we are constrained by our membership of the European Union.

Karen Lee: indicated dissent.

Victoria Atkins: The hon. Lady shakes her head, but I am afraid that that is the law. We have lowered the rate to the lowest possible level—5%—and, what is more, we are using that money specifically for funds that help women and girls. We are waiting for the moment that we leave the European Union. I know that my Treasury colleagues are looking at exactly that issue.

Paula Sherriff: It is a stain on our society that there are young girls and women who are experiencing period poverty, and, frankly, it is tragic that our Government appear to have such ambivalence towards period poverty, although I welcome the latest announcement. Will the Minister agree to work with me on an innovative scheme, which is currently in its infancy, that I am running with a local supermarket to see how we can work towards the elimination of period poverty?

Victoria Atkins: I would be delighted to meet the hon. Lady to discuss this issue, because it is important. We know that we do not have a substantial basis of evidence on period poverty, but we are trying to gather that evidence, particularly with schools. We do want to address the issue of the VAT charged on tampons and other sanitary products, and the moment that we leave the European Union we can do so. In the meantime, we are using the money raised by that low rate of VAT to help women and girls, particularly using those funds that deal with violence against women and girls. We  have a general programme with 12 sub-themes, including period poverty. I very much hope that that money will be of good use.

Dawn Butler: Last week, the Minister asked us to remember the suffragettes chained to the grilles. I ask the Minister today to remember those women chained to the house because of period poverty, those women chained to poor housing because of universal credit, and those women chained to an abusive partner because of the closure of refuges. Will the Minister work with me to develop and implement policies to help tackle those issues?

Victoria Atkins: The Government are led, if I may say, by a female Prime Minister—I just mention that as a small detail because Labour members have never managed to entrust the leadership of their party to a woman. We are proud of our record of helping women, which is precisely why we are bringing forward a ground-breaking piece of legislation this year to tackle domestic abuse, which will help both the victims of domestic abuse and their children. It is one measure in a long programme that we are carrying out to try to help women—not just women who are victims of crime, but women in the economy. We have more women in the workplace than ever before, and we all know that financial independence is a key indicator when it comes to ensuring that women are not stuck in those terrible relationships that the hon. Lady has described.

Gender Pay Gap

Stella Creasy: How many and what proportion of employers within the scope of the gender pay gap regulations have published gender pay gap data.

Bambos Charalambous: How many and what proportion of employers within the scope of the gender pay gap regulations have published gender pay gap data.

Alex Sobel: How many and what proportion of employers within the scope of the gender pay gap regulations have published gender pay gap data.

Daniel Zeichner: How many and what proportion of employers within the scope of the gender pay gap regulations have published gender pay gap data.

Paul Sweeney: How many and what proportion of employers within the scope of the gender pay gap regulations have published gender pay gap data.

Amber Rudd: So far, more than 7,500 employers have registered their intention to report, and around 1,000 have published their data. The most recent data published by employers are publicly available via the Government viewing service on the gov.uk website. There is still more than a month until the public and private sector deadlines, and we expect reporting activity to increase significantly in the run-up to those dates.

Stella Creasy: One challenge that we face is that employers sometimes deliberately conflate fair pay with equal pay to avoid scrutiny of their conduct. A prime offender is the BBC. Seventy MPs wrote to the Secretary of State for Culture to ask him to use his power to ensure an equal opportunity for both men and women at the corporation to be heard on this subject. Given that he has refused to do so, will the right hon. Lady exercise her freedom of speech and have a word?

Amber Rudd: I thank the hon. Lady for raising this important matter. It has been instructive to see how the BBC has responded. I am happy to confirm that I will take forward her advice and indeed have a word.

Bambos Charalambous: What sanctions will be put in place for those companies that do not meet their obligations to publish their gender pay data by the deadline?

Amber Rudd: The hon. Gentleman asks an important question. We have put in place ground-breaking legislation to ensure that we close the gender pay gap. The Equality and Human Rights Commission will oversee any sorts of sanctions that are necessary. I hope that it will be its intention, as it is ours, to use persuasion and demonstration of the law to get participation, but of course it can use the full force of the law if it finds that the legislation is not being complied with.

Alex Sobel: What measures are the Government undertaking to work with private sector business, civil society and others in order to close the gender pay gap?

Amber Rudd: It is incredibly important that we do address closing the gender pay gap. Transparency is one of the key ways that we will achieve that. Having this compulsion of reporting on gender pay is an important first step, but we will take it further. We will engage with businesses to see what measures they will be putting in place to address the gender pay gap. My experience, when I talk to businesses about this, is that when they realise that they have such a gender pay gap—to some, it is a revelation—they are moving to put in training and other measures to address it.

Daniel Zeichner: Only three universities have so far reported on this. On a day when academics are bravely standing up to defend their pensions, will the Minister tell us when she expects that the gender pay gap will be eliminated in our universities?

Amber Rudd: I urge all universities to address reporting their gender pay gap. It is the law; they need to do so. I will say a word on the other matter, if I may. It is important that this dispute between students, effectively, the universities and their staff is resolved, because people need to get their degrees. I would urge the striking lecturers to get back to work.

Paul Sweeney: So far, only 1,000 out of 9,000 companies that are obliged to publish gender pay gap data have done so. What are the Government going to do to up that figure and ensure that companies are meeting their obligations to publish this vital data so that we have the full picture?

Amber Rudd: It is vital data, and Conservative Members are proud of it because it has been introduced by a Conservative Government. We will be contacting private sector companies, and public sector organisations, to make sure that they do report. This is an important first step, with 1,000 so far and more to go until the deadline. I urge the hon. Gentleman not to make perfect the enemy of the good.

Philip Davies: When the Minister has a word with the BBC, will it be her contention that it is the men who are overpaid or the women who are underpaid?

Amber Rudd: That is almost a philosophical question from my hon. Friend. My priority is equality: that is the point I will be making.

John Bercow: Amongst other things, I have always thought of the hon. Member for Shipley (Philip Davies) as a philosopher—[Interruption]—of some distinction.

Women Standing for Election

Alan Mak: What steps the Government are taking to encourage more women to stand for election to public office.

Amber Rudd: I am proud to be part of the most diverse Parliament  in history. My hon. Friend is of course making his  own contribution by being the first British-Chinese Member of Parliament, for which I welcome him. We are commissioning evidence to identify strategies to overcome barriers to participation. Through our centenary fund, we are supporting projects to get more women involved in all levels of governance and ultimately to stand for elected office.

Alan Mak: I thank the Minister for her answer and for her kind words. Twelve women Conservative councillors currently serve on Havant Borough Council, giving over 100 years of collective service. Will my right hon. Friend continue to support women into elected office at local government level and congratulate my friends locally on their service?

Amber Rudd: That is such a good question from my hon. Friend. It is so important that we also encourage women to participate more in local councils. Only 33% of local councillors are women, and I would like to see that number rise. I echo his thanks to his local councillors. I pay particular tribute to Councillor Gwen Blackett, who is soon to retire from Havant Borough Council following 45 years of service. I congratulate her on that, and congratulate the other women who have served as well.

Joanna Cherry: The first woman to be elected to this Parliament was, of course, Countess Markievicz, an Irish nationalist. Is the Home Secretary, like me, looking forward to the presentation of a portrait of the Countess next week by the Irish Speaker in the Irish Parliament to Mr Speaker in this Parliament?

Amber Rudd: Yes, I am looking forward to that, and I will make sure it is in my diary so that I can join the hon. and learned Lady for the event.

John Bercow: Splendid. I look forward to the presence of the Minister for Women and Equalities. That will confer some additional glitter on our proceedings.

Topical Questions

Anna McMorrin: If she will make a statement on her departmental responsibilities.

Amber Rudd: I would like to update the House on the work we are doing to support people back into paid work after time spent caring for others, of whom 90% are women. We know that too often, people with skills and experience struggle to get back into jobs after taking time out of the labour market to care for children or other family members, and that is a huge loss for the economy, employers and those individuals. That is why we committed £5 million to support people back into work in last year’s spring Budget.
In the summer, we also announced new public sector programmes for returners, and I am pleased to inform the House that programmes for people wanting to return to jobs in social work and the health professions and a programme for people wanting to join the civil service after a break are all up and running. Next month, we will be launching practical guidance to help private sector employers get more returners back at the right skill level. I will continue to expand opportunities for people who want to return to employment, and I look forward to giving the House further updates.

Anna McMorrin: Tomorrow in my constituency of Cardiff North, I am hosting a pensions inequality meeting for women born in the 1950s. When will this Government be prepared to support these women all over the country who are being shamelessly exploited and robbed of their pensions?

Guy Opperman: This legislation was passed in 1995 to create an equality between men and women. Those who seek to change the legislation would be effectively creating an inequality between men and women on an ongoing basis that has a dubious nature in law and an inequality between 1950s-born women and 1960s-born women.

Vicky Ford: In this important centenary year, what steps are the Government taking to tackle the online abuse of women in public life?

Amber Rudd: I thank my hon. Friend for that question. It is so important to protect women particularly, who get the largest share of abuse, from the type of attacks that can put them off participating in public life. That is why my right hon. Friend the Prime Minister announced a review that the Law Commission will do to ensure that what we say—what is illegal offline is illegal online—is  actually the case and that the law is following that guidance. We will come back to the House with further updates.

Angela Crawley: I welcome the draft Domestic Violence and Abuse Bill. As well as looking at new initiatives, I hope that it will consider the impact of Government policy on domestic violence. Will the Minister give a commitment that the child maintenance reform will include the abolition of the 4% tax on survivors of domestic violence? Will she ensure that that is included in the draft Bill?

Guy Opperman: I am grateful to the hon. Lady for her question. I will refer to colleagues who are working on specific matters in relation to child maintenance, and we will make sure we write to her with a response on that important point within a week.

Simon Clarke: Some 89% of those who take time out of work to fulfil caring responsibilities are women, and employers, as my right hon. Friend has identified, have a huge role to play in helping women to return to work when they wish to. Can she set out more detail about the plans to publish guidance on best practice for private sector employers?

Amber Rudd: I completely agree with my hon. Friend that this is a priority. It is a priority for individuals, employers, families and the economy, which is why we allocated £5 million in the last spring Budget to make sure that we set up programmes for training, guidance and supporting businesses and employers in achieving exactly that. I will have further announcements on this and look forward to making them to the House.

Carolyn Harris: The Department for Education is currently reviewing relationships and sex education. Has the Minister taken the opportunity to emphasise to her Education colleagues how important it is to identify female genital mutilation and child, early and forced marriage as a priority area in the curriculum?

Amber Rudd: I am incredibly proud that this Government have made that commitment, and we are going to consult on it to ensure that we get it right. It is important to distinguish between relationships education, which is going to be compulsory in primary schools, and sex and relationships education in secondary schools. The areas the hon. Lady highlights will of course be considered as part of that, but this Government have actually have done a lot to address the scourge, unpleasantness and horror of forced marriage and FGM.

Anne-Marie Trevelyan: Will the Minister update the House on what the Government are doing to improve female eligibility for auto-enrolment both nationally and in my constituency of Berwick-upon-Tweed?

Guy Opperman: In 2012, the overall participation of female employees in workplace pensions was 58%, but this has now increased to 80%, which is above the figure for men. In my hon. Friend’s constituency of Berwick-upon-Tweed, 1,020 employers have enrolled 6,000 employees into an auto-enrolled pension, including a very large  proportion of women. I will update the House with the number of auto-enrolled employees in every constituency very shortly.

Ruth Cadbury: What steps are the Government taking to ensure that women are not asked about their family plans or their childcare arrangements in job interviews?

Amber Rudd: I think I can honestly say to the hon. Lady that I was as shocked as she no doubt was to hear about that. I will be discussing it with the Equality and Human Rights Commission and finding out what further communication to employers is needed to ensure that that does not take place, because it is clearly not allowed.

Maria Miller: Businesses have just two weeks to file their gender pay gap reports. It is clear from some excellent investigative journalism by the Financial Times that some businesses have filed incorrect data. If this is done deliberately, what will my right hon. Friend do?

Amber Rudd: I thank my right hon. Friend for raising that issue. This is incredibly important to get right. The reporting on the gender pay gap will be a vital tool in ensuring that we close it. I will be discussing it with the EHRC, which is the group that will follow up with enforcement. It is sufficiently funded to do exactly that, and I will be turning to it to ensure that this is handled properly.

Justin Madders: With reference to the BBC and the gender pay gap, I have been looking at the diversity and background of the senior management at the corporation. Unfortunately, they will not play ball and give me the information I need to judge how they are doing in terms of diversity and social mobility, so will the Minister have a word with them about this as well?

Amber Rudd: It looks as though I will have a few things to take forward with the BBC, and I look forward to coming back to set out what those conversations have revealed.

Bob Blackman: Following the consultation that ended last September, when will my hon. Friend bring forward proposals to remove caste as a protected characteristic from the Equality Act 2010?

Victoria Atkins: My hon. Friend has of course done so much work on this issue. We are very clear that discrimination on the basis of caste is not acceptable, which is why we consulted on it last year. We are considering the results of the consultation as we speak, and the Government will respond shortly.

Kelvin Hopkins: What discussions have Ministers had with minority communities women’s groups, and how do the Government propose to address their specific concerns?

Amber Rudd: I have had a number of conversations with minority communities women’s groups. When I go out to discuss issues to do with integration, I always make a special point of engaging with women’s groups  and finding out what else we can do to help them. Their concerns are often those that the hon. Gentleman and I might have about our own families—access to jobs, language courses and general public services—and my right hon. Friend the Housing, Communities and Local Government Secretary will shortly bring forward an integration strategy that will address some of those concerns.

Matt Warman: May I urge the Home Secretary, when she has her excellent ongoing conversations with social media companies on the west coast, to don her ministerial hat as the Minister for Women and Equalities and look at what those companies can do proactively to ensure that women in particular are not put off from going into public life?

Amber Rudd: My hon. Friend is absolutely right: the issue of the abuse of women online does put women off, and we need to make sure that less takes place in order to encourage them. The experience of my recent visit to the west coast to discuss high levels of crime online with the communications service providers—the internet companies—was productive. We have got them to agree to a number of additional measures that I think will persist.

Wera Hobhouse: Will the Minister consider criminalising upskirting to end that degrading and humiliating practice?

Victoria Atkins: Upskirting is a modern phenomenon, and it is fair to say that the law has not quite kept up with modern habits. It is an issue of which I am aware, not least because my police and crime commissioner campaigns on it thoroughly. The Government are considering the issue, and perhaps in due course I could meet the hon. Lady to discuss it with her.

Chris Davies: What ongoing work are the Government doing to tackle domestic violence?

Amber Rudd: I reassure my hon. Friend that we take domestic violence very seriously. We will shortly bring forward a consultation ahead of a new domestic violence   Bill that will address that heinous crime and, I believe, start to reduce the amount of domestic abuse and violence that exists in this country.

Layla Moran: There is strong anecdotal evidence to suggest that girls are missing days of school due to period poverty. During my Westminster Hall debate, the then Minister for Women said that she wanted to commission research, and in her answer earlier today, the Minister for Women, the hon. Member for Louth and Horncastle (Victoria Atkins) suggested that that has happened. May I ask what has been commissioned, what research is being considered, and when it will be published before the House?

Victoria Atkins: We have sought to establish whether there has been any rigorous national assessment of the prevalence of period poverty and its impact on attendance, but none appears to be available. Last summer we asked for help from the Association of School and College Leaders forum, and we received a limited response. We are trying to produce an analysis of our absence data to look for evidence of period poverty, and we will publish the findings of that in due course.

Peter Heaton-Jones: Further to the Minister’s earlier answer, if the state pension ages of men and women were to be different, would that infringe equality legislation?

Guy Opperman: Potentially yes.

Virendra Sharma: Will the Minister explain what plans the Government will introduce to protect the 200 women and children who are turned away from refuges every single day?

Amber Rudd: I am proud that the Government have more beds available to victims of domestic violence than there were in 2010, and we take very seriously the issue of refuge for those victims. I am not entirely sure that the statistics used by the hon. Gentleman are correct, because sometimes when a woman is not accepted at one refuge and goes on to apply to a second or third, each application counts as one person being turned away. However, I share his view that we want to live in a country where women are not turned away and always have a place to go when they need it.

AIR QUALITY

Neil Parish: (Urgent Question): To ask the Secretary of State for Environment, Food and Rural Affairs, what steps his Department will take to improve air quality after the High Court ruling on 21 February 2018.

Therese Coffey: In July last year we published the UK plan for tackling nitrogen dioxide concentrations. Yesterday the High Court handed down its judgment following a challenge to that plan, and the judge dismissed two of the three complaints that were considered in relation to England. Specifically, he found that there is no error in the Government’s approach to tackling NO2 concentration exceedances in areas with some of the worst air quality problems, and that the national air quality modelling and monitoring that underpin the plan fulfil our legal requirements. On the five cities identified in 2015 as having particularly marked air quality challenges—Birmingham, Nottingham, Derby, Southampton and Leeds—the judge found that the Government’s approach to tackling their exceedances was “sensible, rational and lawful.”
The Court has asked us to go further in areas with less severe air quality problems. We previously considered that it was sufficient to take a pragmatic, less formal approach to such areas. I wrote to several councils in November, and that was followed up by officials who asked them to provide initial information on the action they were taking by 28 February. However, in view of the Court’s judgment, we are happy to take a more formal approach, and I have already written to the local authorities, asking them to attend a meeting on 28 February to discuss that information and their plans, and whether they can take any additional action to accelerate achieving compliance with legal limits of NO2 concentrations. We will follow that up in March by issuing legally binding directions that require those councils to undertake studies to identify any such measures. As required by the Court order, we will publish a supplement to the 2017 plan by 5 October, drawing on the outcome of the authorities’ feasibility studies and plans.
As we set out in the 2017 plan, the Government are absolutely committed to improving air quality. We have pledged to be the first generation to leave the environment in a better state than we inherited it. Later this year, we will be publishing a comprehensive clean air strategy, which will set out further steps to tackle air pollution more broadly.

Neil Parish: Minister, I believe that you are working very hard to improve air quality. This is not just about legislation; it is about practical actions to improve air quality. Are you, as Minister, getting enough co-operation from other Government Departments, including enough money from the Treasury, to address this serious issue? A Department for Environment, Food and Rural Affairs report found that particulate matter pollution costs some £16 billion a year and dramatically affects people’s lives. Does the Minister agree that preventive action would be far more cost-effective?
The High Court did find that the Secretary of State’s approach to the timetable is “sensible, lawful and rational” but not enough leadership is being provided in respect of all the local authorities with illegally high air pollution levels. Does the Minister agree that a new clean air Act will provide proper leadership, while allowing local authorities real autonomy to address the pollution levels they face at a targeted local level?
I welcome that the Government can be held to account through the courts and through Parliament, but does the Minister agree that the judgment is too focused on compliance when what we need is a much more detailed, wide-ranging and practical air quality plan? Clean air should be a right, not a privilege. I believe we need to hear much more from the Government now and we need to speed up the whole operation of cleaning our air.

Therese Coffey: I thank my hon. Friend for that. It is important, as he points out, to remember what we have already achieved on air quality, as well as what we are doing with local authorities. To remind the House, air pollution has improved significantly since 2010: nitrogen oxide emissions are down 27%, sulphur dioxide emissions are down 60%, particulate matter emissions are down by about 11%, and volatile organic compounds emissions are down by 9%. That is why we are investing £3.5 billion to improve air quality and reduce harmful emissions. Some of that is £1 billion to support the uptake of ultra low emission vehicles. Specifically with regard to the air quality plan, we set aside nearly half a billion pounds to help local authorities to develop and implement their local air quality plans. About £90 million has been given through the Green Bus fund and we continue to try to reduce emissions in other ways.
I remind my hon. Friend that we intend to end the sale of all new conventional petrol and diesel cars and vans by 2040. He talked about a wide-ranging plan. I have been working on that for a while. He knows that we will be bringing forward a comprehensive clean air strategy. In particular, I am absolutely focused on particulate matter. That is why we issued a call for evidence on domestic burning with regard to smoky coal and wet wood. We are looking forward to receiving more responses to that. On money from the Treasury, we have been given substantial funds to try to work this through. I agree with him about prevention in relation to issues such as particulate matter.
With regard to powers in a clean air Act, we need clean air action. Councils and Government already have a lot of powers. It is about being prepared to make very difficult decisions at times. That is why I urge the leaders of councils, including those I wrote to yesterday, to really grip this issue on behalf of the people they represent and we represent. It really matters that we take direct, effective local action to ensure the future health of our citizens.

Several hon. Members: rose—

John Bercow: This matter warrants the urgent attention of the House, which is, of course, why I granted the application for the urgent question. However, I am keen that we make timely progress, as the Back-Bench debates are heavily subscribed. There is, therefore, a premium on observation of time limits from the Front Bench and on very pithy inquiries from the back. I know that that will be reflected in succinct replies from the Minister.

Holly Lynch: I have heard the response from the Minister, but the reality is that yesterday the Government’s plan was ruled unlawful for the third time in three years. Here we find ourselves once again having to take the Government to court and having to summon them to the Dispatch Box for them to take any action on this serious issue of public health.
We know that air pollution is responsible for about 40,000 premature deaths each year, with cardiovascular disease accounting for an estimated 80% of all such premature deaths. Research by the British Heart Foundation found premature deaths and diseases attributable to air pollution in the UK result in over £20 billion in economic costs every year. The UK is currently routinely exceeding the legal pollution limits set out in the 2008 EU ambient air quality directive. That poses the serious question of whether this Conservative Government can be trusted with our environment and to deal with illegal air pollution after the UK leaves the EU, given the kind of ducking and diving we are witnessing now.
As the Select Committee on the Environment, Food and Rural Affairs has stated, this situation has escalated into a public health emergency, yet the Government’s attitude and actions do not appear in any way to reflect the severity and urgency of the situation. A press statement released by the Government yesterday appeared to try to spin the Court ruling—we have heard it again today—as some sort of win for the Government and played down responsibility for this incredibly serious failure. It is typical of a Government who provide high talk on the environment but are not capable of demonstrating  the leadership and action necessary to make changes on the ground when it really counts.
Given that the matter has effectively been taken out of the Government’s hands, through what is an unprecedented step, does the Minister recognise her Department’s chronic failure to grasp the nettle on this issue? Will she confirm whether the Government plan to appeal the latest Court ruling? I understand that leaders of the affected local authorities have been invited to a workshop on 28 February. Will the Minister outline the purpose of the workshop and, crucially, what support will be made available to support those cash-strapped local authorities in delivering the action we now need?

Therese Coffey: As I have said before, I take this issue very seriously. I am not surprised that the hon. Lady failed to mention that the Welsh Labour Government were also a defendant in the judicial review. Welsh Ministers admitted that the Welsh element of the air quality plan last year did not satisfy the legal requirements, which is why they have undertaken to publish a supplemental plan. Frankly, therefore, the issue is not confined to the Minister at the Dispatch Box today.
Present problems with air quality in the UK are a direct result of the EU’s failed emissions testing regime, the actions of certain irresponsible car manufacturers and the rapid increase in the number of diesel cars on the roads since 2001. I should also point out that 21 other EU member states are also breaching legal air quality limits. I try not to take a partisan approach on this, but I am fed up with the Opposition simply not accepting their part of the responsibility. It was the last Labour Government who incentivised diesel cars. Between 2000 and 2010, the sale of diesel cars shot up from 15% to nearly half of all vehicles sold. I am not saying  that previous Labour Ministers did not act in good faith but, as we have found out through a freedom of information request, Labour ignored advice that diesel fumes were toxic and pushed on, on the basis of lowering CO2 emissions.
We do not intend to appeal the ruling because, in essence, the judgment turned on a narrow issue: that areas with shorter-term exceedances ought to be mandated to take action. We had already asked local authorities to do that and are more than happy to say that we will now issue legally binding directions stating that they need to take action. We will work with them. We had already asked them to provide initial information and plans, and we are now asking them to come to London next week so that we can go through those in detail and talk through the kinds of resources they need to ensure better air quality for the citizens we all represent.

Andrew Selous: Will my hon. Friend impress upon colleagues across Government that this is not only an issue of fundamental social justice for many of our poorer citizens but about strengthening the UK economy, given that clean air is a business advantage? We do not want to fall behind Norway, the Netherlands and Scotland, which are looking to ban petrol and diesel cars by 2025, 2030 and 2032 respectively. Let us make sure that England is at the forefront, socially just and globally competitive on this issue.

Therese Coffey: My hon. Friend will be aware that the Government are working together to try to improve air quality. He will recognise that air pollution has already improved significantly since 2010. That is why we are working with local authorities to devise local solutions to make this happen. He mentions Scotland. Yes, the Scottish Government are also working on the introduction of a low emissions zone, but I can assure him that the situation in Glasgow is very serious, and I am sure that the Scottish Government, with the support of SNP MPs, will work to ensure they have effective solutions for their citizens, too.

Hannah Bardell: With three High Court cases lost, how critical does this situation need to get before the Government act? I appreciate the Minister’s words, and she mentioned Scotland, where all local authorities with air quality management areas now have action plans. We have set more stringent air quality targets than the rest of the UK and are the first country in Europe to legislate for particulate matter 2.5—a pollutant of special concern for human health. Perhaps I can help her out and meet her, because she will know the work that I have been doing on the aviation noise authority and making sure that it is independent. I wonder whether she would consider ensuring that pollution is taken into consideration and is part of its remit. In my Livingston constituency, I have set up a local noise authority, which ensures that the community can engage meaningfully with airports, airlines and Government. Will she commit to ensuring that the aviation noise authority is truly independent and that the monitoring and management of pollution is also within its remit?

John Bercow: The hon. Lady now has the opportunity to breathe, and I am sure that she will find it a most welcome opportunity.

Therese Coffey: We all have the opportunity to breathe clean air in here, thanks to the excellent work of the House. The hon. Lady talked about the aviation noise authority. I am not a Transport Minister, so I am not aware of the issues that she raised, but there is no doubt that we want to continue to want to reduce emissions from aviation. That is why we are already working with other countries; I have instigated some elements on that. With regards to what is happening in Scotland, she will be aware that, in the Glasgow area, compliance with the legal limits is not predicted until 2026, so yet again, the money that we are investing in England has consequences for the Barnett formula. That will help the Scottish Government to achieve some of the outcomes that she wants. I will have to ask her to contact Transport Ministers to discuss the other matters that she deliberated on.

Mike Wood: I welcome my hon. Friend’s proactive work on air quality, including in Dudley, and I urge her to work closely with local authorities to ensure that our air is clean and safe.

Therese Coffey: I thank my hon. Friend for that. Dudley is one of the areas that has been named. I have already been in conversation with Andy Street, the Mayor for the west midlands. He is very ambitious on the plans to make these improvements and I look forward to meeting the leader of Dudley Council next week to discuss further specific issues.

Mary Creagh: If the UK leaves the EU, the Commission and the European Court of Justice lose their role in monitoring and enforcing air pollution standards. Back in November, the Environment Secretary told my Committee—the Environmental Audit Committee —that he would consult on a new body to fill that governance gap very early in the new year. When will we see that consultation? Will that body be in place before exit day? Will it have higher environmental standards, which is what the Environment Secretary says he wants, lower standards, which is what the Brexit brigade wants, or full regulatory alignment with the EU, which is what the Prime Minister has promised her EU colleagues?

Therese Coffey: The good news is that the House has put legislation in place—we brought this forward—on the targets for 2020 and 2030 on the key pollutants. This Government have already acted and laid the legislation. I am pleased that the House endorsed that approach.
The consultation will be forthcoming soon. I am conscious that people are eager to see it but, in the meantime, we are not relying on the EU to help with air quality. The hon. Lady will be aware of many measures that we are undertaking, including the new bypass in her constituency, which I and my officials believe will be the solution to improving air quality for the people  of Wakefield.

William Wragg: The A6 corridor in my constituency is among the most congested and worst-polluted roads in the country. What conversations has my hon. Friend had with the Department for Transport on road building to alleviate congestion and therefore improve air quality?

Therese Coffey: The Department for Transport has been active. The Government have one of the largest transport investment programmes that there has been for many decades. I am not particularly aware of the road to which my hon. Friend refers, but I am confident that my hon. Friends at the Department for Transport will be. One thing that we have done with the clean air fund is make sure that air quality is a key criterion in assessing particular grants in the future.

Tony Lloyd: In Greater Manchester, like in many other areas, the real issue with nitrogen oxides is from heavy goods vehicles and old buses. We have to begin to think about a bus scrappage scheme and incentives to get old lorries off the roads. How would the Minister respond to that?

Therese Coffey: The good news is that we had already invested £89 million in helping authorities to convert their buses, and another £40 million was added. When I visited the councillors involved in Manchester some time ago, they indicated that they are likely to use the powers under the Bus Services Act 2017 to ensure that they can do more on scheduling and requiring buses to be Euro 6 compliant in future. That is why we have been funding local councils right around the country to make that transition.

Philip Hollobone: How much will air pollution be cut by the ban on the sale of petrol and diesel vehicles by 2040?

Therese Coffey: The expectation from the targets that we have legislated for is that the impacts of air pollution will be halved by 2030. One reason for saying that we will end the sale of conventional petrol and diesel cars by 2040 is to give a strong message to the manufacturers. We have seen a response already in that a number of manufacturers are saying that they will stop the production of such cars by the end of this decade. That is good news for people not only in the United Kingdom, but across Europe and the wider world.

Anna McMorrin: For the last seven years the UK has been in breach of EU limits on toxic pollutants linked to respiratory and cardiovascular conditions and stunted lung growth in young children. It is no use telling the parents of a seven-year-old that things will improve by 2030. Can we see greater urgency, more resources, more action now, and those responsible holding up their hands and admitting when they have got it wrong?

Therese Coffey: I am sure the hon. Lady will be talking to Lesley Griffiths and the Welsh Labour Government, because it is a devolved issue. They contributed a part of the 2017 air quality plan. Just a few months later, they recognised that it was not good enough, and said they were going to do more. That is why we have  been working with the Welsh Government to make improvements, and why at a national level we are taking measures regarding fleet turnover and incentives to move to the cleanest diesel possible for those people who still want to use diesel cars in the interim. That is also why we are taking measures such as increasing company car taxation on diesel cars. We are taking measures, but it is not usual practice for the UK  Government to order the Welsh Government to do something that is devolved. I am sure that the hon. Lady will work with her colleagues in Cardiff to ensure that her citizens are better represented in making the case for air quality with the Welsh Government.

Bob Blackman: Older vehicles are the most polluting, and they tend to be owned by small and medium-sized enterprises or by people on low incomes. Will my hon. Friend look at the potential for a vehicle scrappage scheme for not only buses, but cars and lorries, so that we get the worst-polluting vehicles off the road more quickly?

Therese Coffey: On the air quality plan, we issued a consultation on mitigation measures, and a potential scrappage scheme as part of that. We are still considering the responses, and will report back to the House shortly.

Ruth Cadbury: Yesterday I sat here listening to the Prime Minister’s response to my question, and I was very surprised at the gap between the briefing that she had been given by the Department for Environment, Food and Rural Affairs—albeit, I accept, at short notice—and what I was reading through the news feeds. Will the Minister apologise to me and to the House for the briefing given to the Prime Minister that implied that the judgment was more a win than a loss, given that, as we now know very clearly, the Government have been found to be acting unlawfully, and so badly that the court is taking over DEFRA’s role in implementing the legislation?

Therese Coffey: I am afraid the hon. Lady is simply incorrect. The judge dismissed challenges about our approach to air quality. I wrote to councils last November asking them about how we can help to improve air quality in those 45 local authorities, and the judge said that urging and encouraging was not sufficient, but that we should issue legally binding directions. That was reflected in what the Prime Minister said to the House yesterday, and that is what we will do. I encourage the hon. Lady to work with the Mayor of London, who has already had a substantial amount of funding, which he is using to start deploying cleaner buses and other aspects of modal shift in London. Frankly, he needs to accelerate his programme, and I encourage her to work with him in doing that and building on the plans of my right hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson).

Andrew Jones: I welcome the energy and resources that the Government are applying to this issue, particularly the clean bus funds, which will see a fleet of electric vehicles serving Harrogate and Knaresborough. Are all the local authorities that my hon. Friend is dealing with as committed and enthusiastic as she is about solving this issue? That has not been my experience so far.

Therese Coffey: My hon. Friend was a Treasury Minister when we were working on the air quality plan, and I know that he is as committed as I am to these improvements. I fully recognise that some of the issues involved are politically difficult, which is why I have been meeting  councillors from those authorities to tell them that time cannot wait for effective local solutions. My hon. Friend ensured that we had Government finances with which to tackle the issue, and those finances will be deployed.

Layla Moran: rose—

Wera Hobhouse: rose—

John Bercow: Ah! A Liberal Democrat competition. I call Layla Moran.

Layla Moran: Thank you, Mr Speaker.
I am very grateful to the Minister for her letter and her offer to meet me to discuss the plan for Oxford, which I intend to take up. Will she confirm, however, that it is not just a meeting that she is having with the councils, and that there is also extra money? I know that they have already been trying.

Therese Coffey: I did not mention this earlier, but yesterday I wrote to all Members affected by the impact of yesterday’s legal ruling, which binds the councils legally to co-operate with what we were already doing. I have engaged in correspondence with the leader of Oxford City Council, and look forward to meeting her next week. The council is looking at certain proposals which include widening the pedestrianised area in the city centre in order to tackle the challenges. I want to know what resources or powers it may need, but I think that it has powers already, and it may just be a case of working through the details of the plan.

Chris Davies: Will my hon. Friend give us more details about what the Government are doing to support renewable technology in order to secure the future of clean energy in the United Kingdom?

Therese Coffey: In addition to the £3.5 billion that we are investing to tackle, in particular, air quality in the context of a modal shift, we are massively increasing the incentives for councils to help to deploy the infrastructure that is needed to support the growth in the use of electric vehicles. There is already a reasonably generous grant for people who wish to buy such vehicles—about £1 billion has been allocated—and, as my hon. Friend will know, legislation that is currently before Parliament will require fuel stations to provide the electric infrastructure that enables people to charge their cars, rather than just filling them with petrol and diesel.

Barry Sheerman: As chair of my party’s Back-Bench environment, food and rural affairs committee, may I say to the Minister  that this is not good enough? We are talking about a national health emergency: according to recent estimates, a million people could probably die by 2040. The Minister must act now, with the manufacturers, with local authorities, and with everyone else.

Therese Coffey: I welcome the hon. Gentleman’s support for the effort to get local authorities working on this. He will, I hope, be aware from the letter that I sent him yesterday that we have been in correspondence. We  recently funded a significant number of buses—350, I think—in the West Yorkshire combined authority, and there is clearly an opportunity for those new buses to be deployed in the worst traffic hotspots so that we can work on air pollution. I look forward to meeting the leader of Kirklees council and other West Yorkshire authorities next week.

Wera Hobhouse: I thank the Minister for meeting me a couple of weeks ago to discuss specific Bath issues. She was helpful and pragmatic. I agree that local leadership is needed.
The Minister mentioned the new legislation earlier. I do not think that it goes far enough. May I ask again whether she will consider introducing regulations requiring owners of public facilities such as supermarkets and public car parks to provide electric car charging points?

Therese Coffey: I did have a very constructive meeting with the hon. Lady recently. I also visited Bath last year to see at first hand the challenges that it is facing. The hon. Lady will know of the grants that have already been provided to increase electric vehicle take-up. However, I take her point, and I will discuss it with the Under-Secretary of State for Transport, my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman).

Anneliese Dodds: Oxford was excluded from the mandated list because only 3% of our monitoring sites were included. Do the Government now accept that that decision was wrong, and that, as the first British city to commit itself to a zero-emission zone, we really need the powers and resources that she mentioned?

Therese Coffey: Oxford City Council already has those powers. It could have done this years ago. The powers were granted some time ago in the Transport Act 2000. The judge yesterday upheld the fact that our modelling had fulfilled our legal requirements, although I am conscious that the local air monitoring does not comply with the legislation by which we are bound. I am pleased that Oxford is considering wider pedestrianisation in its city centre, and I look forward to discussing that in detail next week. However, it has those powers already. It can get on with this, and I encourage it to do so as quickly as possible.

Thangam Debbonaire: Although I am grateful to the Minister for the funding she has given to cash-strapped authorities such as Bristol for consultations on clean-air zones, I would like her to move a little further and think of the children who are  at school in one of the worst-polluted areas in the centre of Bristol, St Michael on the Mount Without. Will she urgently consider a scrappage scheme for cars and other vehicles, such as taxis and buses?

Therese Coffey: I have discussed air quality with the hon. Lady before. She will be aware that I have had direct discussions with Bristol City Council. She will also be aware of the funding that has already gone in to help the uptake of electric vehicles and the buses that are being provided from transport funds. Bristol is making good progress. It is one of the councils that we mandated last year to come forward with action; I believe that it is on track, mainly, with its process and I look forward to receiving its final considerations later this year.

Rachael Maskell: After eight years of court cases, I find the Minister’s minimalistic approach quite staggering. Why are her Government investing in a new generation of dirty diesel trains, which are a major issue in my constituency, as they idle outside residential areas?

Therese Coffey: As my hon. Friend the Member for Orpington (Joseph Johnson), the Rail Minister, said, we are going to end the use of diesel-only trains by 2040. That has given a clear steer to the procurers and operators, on the basis that they tend to invest in 15-year cycles. Our rail electrification programme is considerably greater than that of the Labour Government, who, when in power for 13 years between 1997 and 2010, achieved 13 miles, so frankly, it is not for Labour Members to lecture us today about these issues. Since 2010, we have been investing to fix the problems that they left behind.

Nick Smith: Three years after the Volkswagen story broke, how are the Government holding the company to account for its emissions scandal?

Therese Coffey: We have been holding Volkswagen to account. One of the challenges of how the EU operates in this regard is that it is for the German Government to be the regulator of Volkswagen, and we hold Volkswagen directly to account through the European Commission. I am pleased that Volkswagen has come forward with its wider group to do some of the retrofitting of vehicles in terms of software updates to correct what it did, and I am pleased that that is now being fixed, but frankly, the behaviour of Volkswagen and its chief executives was a disgrace. The way they used money to fund research into the effects of diesel fumes on primates and humans is frankly disgusting. They should hang their heads  in shame, but we are now fixing the problems that  they created.

BUSINESS OF THE HOUSE

Valerie Vaz: Will the Leader of the House give us the forthcoming business?

Andrea Leadsom: The business for next week will include:
Monday 26 February—Estimates day (1st allotted day). Debate on Ministry of Defence estimates followed by a debate on the estimates of the Department for Exiting the European Union.
Tuesday 27 February—Estimates day (2nd allotted day). Debate on the Ministry of Housing, Communities and Local Government estimates so far as they relate to homelessness, followed by a debate on the estimates of the Department for Transport.
At 7 pm the House will be asked to agree all outstanding estimates.
Wednesday 28 February—Proceedings on the Supply and Appropriation (Anticipation and Adjustments) Bill, followed by debate on a motion on the independent complaints and grievance policy. The Chairman of Ways and Means has named opposed private business for consideration.
Thursday 1 March—Debate on a Backbench Business Committee subject to be confirmed followed by general debate on St David’s day. The subject of this debate was nominated by the Backbench Business Committee.
Friday 2 March—The House will not be sitting.
The business for the week commencing 5 March will include:
Monday 5 March—Second Reading of the Data Protection Bill [Lords].
Mr Speaker, colleagues will also wish to know that, subject to the progress of business, the House will rise for the summer recess at the end of business on Tuesday 24 July and return on Tuesday 4 September. For the conference recess, the House will rise at the close of business on Thursday 13 September and return on Tuesday 9 October. The House will also rise on Tuesday 6 November and return on Monday 12 November and finally, for the Christmas recess, the House will rise at the conclusion of business on Thursday 20 December and return on Monday 7 January 2019.
This week, the very best of British has truly been on display. A number of Sunday’s British Academy of Film and Television Arts awards went to Brits, including the awards for best cinematographer and for rising star, and of course Gary Oldman won an award for playing none other than Winston Churchill in “Darkest Hour”. We have all been glued to our televisions watching our best-ever winter Olympics performance. We won three medals in one day, with Lizzy Yarnold successfully defending her gold in the skeleton. Sports and the arts are not just of huge value to British culture; they are also of huge value to our economy, and they have been showcased superbly this week.
This has also been a week of important firsts for women. Congratulations to the first Lady Usher of the Black Rod as she takes up her role, and to Minette Batters, who has been selected as the first female president of the National Farmers Union. Finally, Her Majesty  was still achieving firsts as she appeared on the front row at London fashion week and presented an inaugural award in her name.

Valerie Vaz: I thank the Leader of the House for giving us the business for next week. However, I must echo what Marin Alsop said: it is the 21st century, yet we are still celebrating firsts for women. That must change.
It is helpful to have next week’s business, and I am sure that Members and staff of the House will be pleased to have the recess dates. I note that the business stops on 5 March. Can the right hon. Lady tell us what is going to happen after that, or will the Government continue to announce just one week plus a Monday in advance? If they are looking for something to fill the time, perhaps the Leader of the House could provide us with another Opposition day. I think the last one that was allocated was on 24 January.
Obviously there is time available as the Government do not have any business, so could we consider two statutory instruments that have been prayed against by my hon. Friend the Member for Ashton-under-Lyne (Angela Rayner)? The first relates to early-day motion 936, on changing the eligibility of free school meals for those on universal credit.
[That an humble Address be presented to Her Majesty, praying that the Free School Lunches and Milk, and School and Early Years Finance (Amendments Relating to Universal Credit) (England) Regulations 2018 (S.I., 2018, No. 148), dated 6 February 2018, a copy of which was laid before this House on 7 February, be annulled.]
The second relates to early-day motion 937, which deals with regulations abolishing nursing bursaries for postgraduate nursing students.
[That an humble Address be presented to Her Majesty, praying that the Education (Student Support) (Amendment) Regulations 2018 (S.I., 2018, No. 136), dated 5 February 2018, a copy of which was laid before this House on 6 February, be annulled.]
Could the Leader of the House honour the convention and allow time to debate those matters on the Floor of the House, so that we can have a vote on them before the 40-day period expires?
Will the Leader of the House tell us what news she has of the Trade Bill and the Taxation (Cross-border Trade) Bill? I am sure that the Government will want to scotch rumours that they are being pushed away.
I thank the Leader of the House for her letter—which I received at eight minutes past 8 yesterday—responding to some of the queries that I had raised. It was a bit like the Morecambe and Wise joke in which Eric tells André Previn that he is playing all the right notes, but not necessarily in the right order. In her letter, she answered questions, but they were not necessarily the ones that I asked. On the east coast railway line, for example, I did not ask her to tell me how wonderful Virgin was. I asked her a question about the Secretary of State taking back the contract. I asked her to write to me to tell me what costs were associated with the privatisation in the first place, and with taking the contract back. I also asked whether the Secretary of State had made the decision to privatise a commercially viable service against the advice that had been given to him.
The Leader of the House also did not answer my question about the inspector looking into Northamptonshire County Council. I asked her let me know how long the inspection would take and what the terms of reference were. We also know that Buckinghamshire might be setting an illegal budget—this will be of interest to you, Mr Speaker—and I think that that might be happening today. Over the past five years, its Government support has been reduced from £61 million to £8 million. The Leader of the House needs to respond to that. I ask her this as a matter of courtesy: I know that she has a very able civil service staff, because I meet them on occasions, and I wonder whether she could sign her letters off slightly earlier—perhaps on a Tuesday?
We know from the book by Tim Shipman how the Government used to make their policy, with the two advisers walking in St James’s Park batting policy ideas back and forth. Now that they have lost their jobs, however, it seems that the Government are raiding the Labour manifesto. They are now having a review of tuition fees. It is irrelevant that more young people are going to university—they have been told that if they go to university and get a degree, they will get a better job, but students do not want to start off in life with a debt of £56,000. However, they receive invoices yearly telling them that they have to pay back that amount.
The matter of high pay rises for vice-chancellors was raised during the Education Committee hearing on value for money in higher education, and MPs told a panel of vice-chancellors that the high rate of pay enjoyed by some university leaders is immoral given taxpayer subsidies and rising levels of debt. Will the Government therefore consider that issue in their review of post-18 education? If they will not—we do not know the full terms of reference—may we have a debate on the possibility of further regulation of vice-chancellors’ pay, or will that be parked for another year?
It is almost a year since article 50 was triggered, and at the end of the weekend we may know exactly what the Government’s position will be. I do not know whether you received a copy of the letter to the Prime Minister, Mr Speaker, but although it is marked private and confidential it seems that everyone has seen it. If you have not received it, I am quite happy to give it you. It is actually disrespectful to the Prime Minister. It begins, “Dear Prime Minister,” but it was sent to her at the House of Commons, not Downing Street—her place of work. I am not even going to go into the grammar or anything else, but I want to highlight one thing. It states that leaving the customs union and single market
“isn’t a question of ideology, but practicality”.
There is absolutely no mention of what is in the best interests of the citizens of this country or the interests of Northern Ireland. The right hon. Member for Loughborough (Nicky Morgan) was right to say that it reads like a ransom note. It might as well have had a bullet point at the end saying, “Don’t forget to do this,” or, “Do this, or else.” It was signed by 63 Members—well over that magic number of 40.
It is World Thinking Day, which is a day of international friendship. We want to stand by our international friends and with the young people in Florida who decided to remember the 17 people who were murdered last week by walking out of school and into their state capitol to demand change.
The Leader of the House and I could not be at the Brit awards yesterday—I was reading my letter from her at 8.08 pm—but I am sure that she will echo the Leader of the Opposition’s words about a young man who has changed the music industry. He encouraged everyone to vote, pray and speak out about mental health issues, and he won best album and best male artist. Stormzy, congratulations.

Andrea Leadsom: I start by sharing in the hon. Lady’s tribute to those who were tragically murdered before even reaching their prime in the appalling killings in Florida. We were all beyond shocked, and we are all slightly in despair that such things happen time and again. We desperately hope that action will now be taken to fulfil the wishes of those young people, who should be able to grow up in peace and security.
I am always happy to pay tribute to people who speak out about the importance of resolving the nation’s mental health issues. On Tuesday evening, I had the great pleasure of speaking at an event run by MQ, a charity that looks at research into mental health. I met some fantastic people who are doing everything they can to promote good mental health, and I am proud of the Government’s achievements in that area.
I am sorry that the hon. Lady is grumpy about my letter to her. I do my absolute best to be nothing but courteous to the hon. Lady, whom I respect enormously and for whom I have the greatest regard. I share her tribute to my civil service team, but she will recognise that there are only a handful of them, and the questions that she asks sometimes require answers from Departments. With specific regard to her detailed questions on Department for Transport matters, she will know that Transport Question Time happens often in this Chamber, and she is also at liberty to ask detailed questions of the Secretary of State for Transport, instead of being slightly churlish towards my team, who are doing their best on her behalf. I thank my tiny Department for its excellent turnaround rate on letters.
The hon. Lady talked about some things that I did not include in my response, such as the inspection at Northamptonshire County Council. The inspector’s report is due by 16 March, and I am sorry if that was omitted from my letter. The hon. Member for Halifax (Holly Lynch), who is sitting next to the shadow Leader of the House, has gone on Twitter criticising things that I failed to say in my very courteous and timely response to her. Mr Speaker, perhaps you might like to give your thoughts on how appropriate it is, when one tries to be courteous to colleagues, that they simply go on Twitter accusing me of not saying things that they would have liked me to have said. It is a little discourteous.
The shadow Leader of the House talks about tuition fees and says that the Government are taking a leaf out of Labour’s manifesto. I do not think we ever said that we would scrap tuition fees and deal with all the outstanding debt, which even the Opposition agree would have an appalling impact on our economy. We are seeking to look very seriously at what is the best combination for delivering excellence in post-18 education at an affordable price.
Finally, the shadow Leader of the House raises the issue of a letter from a number of Conservative MPs, and all I can say, as the Prime Minister’s spokesman   made very clear, is that all contributions from Members on both sides of the House to our position on Brexit are very welcome, and all are taken into account.

David Amess: Will my right hon. Friend find time for a debate on support for women with endometriosis? An inspirational constituent, Ms Carla Cressy, suffers from this crippling condition, and she is leading a local and national campaign to raise awareness, which I hope the House will support.

Andrea Leadsom: My hon. Friend raises a serious matter, and I certainly congratulate his constituent on her campaign. Statistics suggest that endometriosis is the second most common gynaecological condition in the United Kingdom, affecting one in 10 women. I encourage him to apply for an Adjournment debate to raise awareness of this condition further.

Pete Wishart: I thank the Leader of the House for announcing the business for next week. I am not sure whether she is going to the Brexit bonding/war session later this afternoon, but can we have a debate on what other dystopian nightmares Brexit will not be quite like? Maybe “Apocalypse Now”— apocalypse in a couple of years?—or “Children of Men”. My favourite would have to be “The Matrix”, as we have a bunch of clueless fantasists living in an alternative world and believing that they can impose their version of reality on everyone else—it could not be more apt than that.
On alternative realities, we had English votes for English laws in all its absurd glory yesterday. Bells go on, bells go off; Mace comes down, Mace goes up. Nothing ever happens. There is no debate and no consideration of all these weighty English-only issues; nothing goes on at all. It is now becoming profoundly embarrassing for this House. EVEL now seems to be designed only to get in the way of the workings and procedures of this House, and it is a psychological barrier to the unity of the membership of this House based on nationality and geography. For goodness’ sake, Leader of the House, get shot of this absurd system.
Lastly, I had the good fortune of being at the Brits last night to see the cream of British musical talent on show. Before you ask, Mr Speaker, MP4 were once again shamefully passed over for the parliamentary rock band of the year. It has taken our musicians to remind this Government to do the right thing, and the hon. Member for Walsall South (Valerie Vaz) is right to mention Stormzy and his tour-de-force performance last night in which he asked, “Where’s the money for Grenfell? You thought we were all going to forget about Grenfell? Well, we are not.” It is great that our actors, our young people and our musicians are reminding this Government to do the right thing.

Andrea Leadsom: On Grenfell, the hon. Gentleman and all hon. Members on both sides of the House will know that resolving the appalling tragedy to enable people to carry on with their lives and to turn around the appalling physical and mental scars from that awful, awful night is an absolute priority for the Government, and it will remain so.
I am glad that the hon. Gentleman was able to enjoy the Brits—the best of British, which is important for someone such as himself—and I am sure MP4 will have their day.
The hon. Gentleman talks about EVEL. He will appreciate that under the devolution settlement it is important that those directly affected should be able to hold the majority on votes affecting only English or English and Welsh situations. Finally, he talks about our life outside the EU, which in my opinion is much less “Mad Max” and far more “Love Actually”.

Ian Liddell-Grainger: I am not even going to try to follow that one, Mr Speaker.
I have just received a report from Data Diligence, which my right hon. Friend will know about, because it pointed out the wrongdoings of Northamptonshire County Council. It has just sent me a report to prove that Taunton Deane Borough Council has been hiding money for years, in financial misprudence. May we please have a debate on this matter? It is important, as it shows that local government is sometimes not worthy of the trust we put in it.

John Bercow: The hon. Gentleman has referred on this occasion to the council. May I just ask him whether he has notified the hon. Member for Taunton Deane (Rebecca Pow) of his intention to raise this matter today?

Ian Liddell-Grainger: I wrote to my hon. Friend, in line with your guidance in your letter. I thank you very much for your guidance, which I followed to the letter.

John Bercow: This is becoming rather tiresome. I did try gently to exhort the hon. Gentleman to pursue other lines of inquiry. I have permitted this today, but my patience is not unlimited.

Andrea Leadsom: My hon. Friend will be aware that business questions are about business of this House, and he would be advised to speak to the Department for Communities and Local Government directly about his concerns.

Ian Mearns: Let me help the Leader of the House by saying that it has just been determined this morning that the other item of business on Thursday 1 March will be a debate on a motion on seasonal migrant workers. That has been settled this morning.
The Department for Digital, Culture, Media and Sport is backing the great exhibition of the north, which is being hosted in Gateshead and Newcastle from 22 June until 9 September. May we have a debate in Government time to promote the great exhibition of the north? I know that the Leader of the House would normally exhort a Member making such a request to go to the Backbench Business Committee, but that would hardly seem appropriate in my circumstances.

Andrea Leadsom: The hon. Gentleman could always go and chat to himself in the mirror, but that might appear a little odd to anyone watching. I pay tribute to  that great exhibition of the north, which I hope will be a huge success. I am sure he will find, as he just has, great ways to promote it.

Bob Neill: May I tell the Chairman of the Backbench Business Committee that there is a famous scene in “Iolanthe” where the Lord Chancellor persuades himself of the merits of his own cause?
May we have a debate on the working practices and procedures of the Education and Skills Funding Agency? There is a particular issue in my constituency with Bullers Wood school for boys. The Secretary of State for Education is very much on the case, but there is an underlying picture of an organisation whose procurement processes are top-heavy, slow, hierarchical and very process-driven. This body is sometimes resistant to advice from external partners, who can often bring greater local knowledge to bear on its procurement processes.

John Bercow: Order. I must just say to the hon. Gentleman that I gather that he was spotted in a prominent place at the first night of the said performance. We hope he richly enjoyed himself.

Andrea Leadsom: My hon. Friend is a big champion for his constituency and for education, and I encourage him to take this up directly with Ministers or through an Adjournment debate.

Emma Hardy: TransPennine Express has recently downgraded the vital rail link from Hull to Leeds and Manchester to a stopping service, which means that trains now stop at an additional six places along the way. Although it is important to have a stopping service to link together smaller towns, it is really important to have an express service, too. Please may we therefore have a debate in Government time on rail connectivity for northern cities?

Andrea Leadsom: The hon. Lady raises an important point. She will be aware that there will be Transport questions on Thursday 1 March, when she might well like to raise that issue directly with Ministers.

John Hayes: The Leader of the House will be aware of the retail giant Tesco hungrily taking over the wholesaler Booker. She will also be aware of the concerns about that on the part of farmers, growers and food producers: it would create an extraordinary distortion of the food chain at the expense of all those important people. Will she encourage those in the Government responsible for agriculture and business to let this House know what their feelings are about such market distortion?

Andrea Leadsom: My right hon. Friend will be aware that there are clear processes for looking at significant takeovers and at mergers and whether they are in the public interest, but he may well wish to raise that directly with Ministers or to seek an Adjournment debate so that he can talk about the particular interests of his constituency, which has a heavy reliance on the agricultural sector.

Gavin Newlands: My constituents in Bridge of Weir have told me that universal credit claimants there are instructed to attend initial appointments in Greenock—nearly 12 miles away—despite the jobcentre in Johnstone being only 3 miles away. I have heard of claimants walking to and from Greenock, as the return bus fare of nearly £8 represents up to 14% of their benefit payment. Can we have a debate on how claimants from rural and semi-rural areas are affected by universal credit roll-out?

Andrea Leadsom: The hon. Gentleman raises a very important point. He will be aware that the Government are fully committed to the roll-out of universal credit as a good way to help more people back into work and have the security of a job and a pay packet. With regard to the specific points he raises about access to jobcentres to sign up for universal credit, if he wants to write to me, I can take them up directly with the Department on his behalf.

Anne-Marie Trevelyan: Please may we have a debate on the communication strategy and responsibilities of Highways England? Two weeks ago Highways England announced the total closure of a key part of the A1 through my constituency for three weeks in March, but it entirely failed to consult, or indeed communicate at all, with vital local businesses such as Purdy Lodge services and with local residents who will be heavily affected by this necessary work. The confusion and the lack of communication have been a real crisis for the area.

Andrea Leadsom: My hon. Friend is absolutely right to raise that. I think a number of hon. Members have had problems with lack of communication about significant road closures, so I am glad she has raised the issue in the Chamber. She may well want to take it up at Transport questions next Thursday, 1 March.

Derek Twigg: When can we have an urgent debate in Government time to discuss the state of our roads and particularly the number of potholes not just on our local roads but on motorways? Anyone who drives on the motorways will see many potholes, which are very dangerous.

Andrea Leadsom: The hon. Gentleman is right to raise the issue of potholes. It is a big frustration for all of us as individuals and in our constituency surgeries—there are lots of complaints about potholes. The Government have invested significant sums in dealing with potholes. There have been improvements in recent years, but the hon. Gentleman might like to talk to the Backbench Business Committee so that Members can share their particular frustrations.

Martin Vickers: My question follows that from my hon. Friend the Member for Berwick-upon-Tweed (Mrs Trevelyan) about the work of Highways England. The A180 into Grimsby and Cleethorpes is our major route, and it is vital to the local economy. It is undergoing unexpected roadworks at the moment, and there was very little consultation. I acknowledge that I could raise this at Transport questions,  but in view of the concern among other Members, perhaps we could find time for a Government debate on the issue.

Andrea Leadsom: I am glad that my hon. Friend is speaking up for his constituency, as always. Again, at least in the first instance, he might want to raise the issue at Transport questions next week.

Barry Sheerman: May I mention the sad death yesterday of the great American evangelist Billy Graham? He was a great influence on many of us in this House. He was very saddened by the killing of children in schools in America, but he would also have been appalled by the daily death toll of children in Syria caused by this ghastly Syrian Government, backed by the Russians, day after day. Can we have an early statement to the House next week on any progress towards a halt in that awful, awful tragedy?

Andrea Leadsom: I certainly share the hon. Gentleman’s tribute to Billy Graham who really was quite a life-changing character for many people during his long life. I also share the hon. Gentleman’s grave concern about what is happening in Syria. The Government have condemned the appalling loss of life, and we will do everything that we can to ensure that there is a ceasefire and that we make progress in finding a resolution in Syria.

Andrew Jones: Last week, in partnership with Disability Action Yorkshire, we brought together leaders from across my constituency —business leaders, service providers and transport providers—to discuss how to make Harrogate and Knaresborough even more friendly for disabled people. It was a very good session, with practical ideas put forward and helpful connections made. Can we have a debate, to build on the debate later today, to look at how we can make the UK more disability friendly?

Andrea Leadsom: I congratulate my hon. Friend on his huge efforts in this area and commend him for the meeting that he called. He might be aware of the Backbench Business debate that takes place later today on the role of disabled people in economic growth. The Government spend more than £50 billion a year on benefits that support disabled people and people with health conditions. That is more than ever before—in fact, it is up £7 billion since 2010—with the result that there are now 3.5 million disabled people in work, which is an increase of nearly 600,000 in the past four years. He is right that there is still a lot more to do, and a lot more that can be done, but we are making some good progress.

Jo Swinson: Last year, a 13-year-old boy with a dairy allergy died after allegedly having cheese forced on him at school. Next month, children at the cinema will watch the much-loved character Peter Rabbit forcing a child to undergo an anaphylactic reaction, which can be fatal. Sony has apologised but has refused to cut the scene, and the film certificate classifies the film as having mild threat and comic violence. Food allergy is no laughing matter; it can be  life or death. Can we have a debate on the bullying of children with allergies, which is clearly not taken seriously enough?

Andrea Leadsom: The hon. Lady raises an incredibly important point, and she is absolutely right to highlight the seriousness of food allergies. We should do everything that we can to raise the importance and the awareness of the potential life-threatening impact of food allergies. She may well want to seek an Adjournment debate so that she can talk to Ministers directly on that point.

Chris Davies: With the lambing season now upon us and domestic dog attacks on livestock at an all-time high, can we have a debate on what more the Government can do to limit the devastating effect that irresponsible dog owners have on both our rural communities and our rural economy?

Andrea Leadsom: My hon. Friend is absolutely right to raise that matter. We have all seen photographs of the appalling effect of a dog attack on a field of sheep. It is hugely distressing for the animals, obviously, as well as for the farmers who look after them, and it has serious financial implications. It is already a criminal offence for a dog to worry livestock; dog owners can be fined up to £1,000. Farmers are being encouraged to report any incidents so that action can be taken. Furthermore, the dog welfare code highlights for owners the importance of keeping their dogs on leads when they are near livestock.

Ian Murray: University lecturers and staff are currently involved in a strike—the largest ever in higher education—owing to changes in their terms and conditions, particularly in their pensions. Can we have a statement, or an urgent debate, in this House about how we can resolve this impasse so that the terms and conditions of our lecturers can be protected?

Andrea Leadsom: I must declare an interest, as my eldest son is about to study for his finals and now has no lecturers. At a very personal level, I cannot say that I support innocent students, who have paid their fees and worked very hard, being punished for the resolution of this challenge. Talks are ongoing, and the Universities Minister is engaging with Universities UK and the University and College Union to make it clear to all parties that there is a need to find a solution that avoids disruption to students.

Mike Wood: Under this Government, the UK is leading international efforts to tackle tax avoidance. Can we have a debate on the impact that tax avoidance has on our vital public services and on what more can be done to make sure that everybody pays their fair share?

Andrea Leadsom: My hon. Friend raises a really important point. He will be pleased, as I am, that the Government have a strong record on tackling tax avoidance, evasion and non-compliance. Since 2010, Her Majesty’s Revenue and Customs has secured and protected over £175 billion in additional tax revenues through its compliance activities—more than the entire annual budget of the NHS. The UK’s tax gap is now down to 6%—its lowest level ever, and one of the lowest in the world.

Ben Lake: We still await the Government’s response to the independent review of S4C that was launched last year. In recent years, the channel’s budget has suffered successive real-terms cuts. What is more, the Wales-specific content broadcast in the English language on other channels has also decreased. May we have an urgent debate on the perilous position of broadcasting in Wales and the merits of devolving responsibility for it to the National Assembly for Wales?

Andrea Leadsom: I certainly share the hon. Gentleman’s enthusiasm and support for the Welsh broadcasting service. He may well wish to seek an Adjournment debate so that he can take up his specific concerns directly with Ministers.

Douglas Ross: May we have a debate on local news sites? Next Wednesday, Stuart Crowther, the editor of InsideMoray, will be publishing his final stories before taking a well-earned retirement. Since that site started in June 2013, it has been a valuable resource for local people and those further afield, and it complements our local print media. Will my right hon. Friend join me in congratulating Stuart on his efforts over the years and share my hope that someone will take over this successful site to ensure that it can continue in future?

Andrea Leadsom: My hon. Friend is a real champion for all things in Moray. I can assure him that the Government are committed to supporting an independent, vibrant and plural press industry. In particular, the local press is vital to this country’s democracy. I know that InsideMoray has published thousands of stories since 2013. I am happy to join him in congratulating Stuart on his amazing efforts and wishing him a very happy retirement.

Paula Sherriff: Year 6 pupils Ella and George from Thornhill Junior and Infant School in my constituency wrote to me regarding their concerns about our dependence on fossil fuels and the harm caused by litter and plastics to our environment. Will the Leader of the House consider, further to today’s urgent question, giving more time for a debate about building a green economy based on clean, renewable energy?

Andrea Leadsom: I congratulate the hon. Lady’s constituents on the really worthwhile campaign that they have started to run. I am sure that she will be delighted to hear of the number of MPs who have taken up the “give up plastic for Lent” challenge. I am not sure whether she has done so herself, but it is surprisingly difficult to stop using plastic. The Government are taking great steps forward through the 5p charge for plastic bags. We are reducing the number of plastic bags in circulation by about 9 billion, or some extraordinary number. There is a huge amount more to do to reduce our use of fossil fuels. We have announced the intention to get coal off the system by 2025. There is a lot more to be done, and so the efforts of her constituents are greatly appreciated.

Bob Blackman: In the past two months alone, 25 civilians and at least seven service personnel have been murdered by terrorists in Jammu,  Kashmir. In Kashmir, illegally occupied by Pakistan, 162 terrorist training bases have been identified. May we have a statement from the Secretary of State for Foreign and Commonwealth Affairs on what we can do in this country to help and support our great ally, India, in combating this terrorism?

Andrea Leadsom: My hon. Friend raises an incredibly serious point. He will be aware that we work very closely with all our allies to try to stamp out terrorism and all terror attacks. He will, I am sure, want to raise this directly with Foreign Office Ministers, or perhaps through an Adjournment debate, so that he can get specific detail on what we are doing to address his point.

Bambos Charalambous: One of my constituents, Ian Ackley, was the initial whistleblower on, and a victim of, the prolific serial child sex abuser and paedophile Barry Bennell. There has been no Government statement or debate about this historical child sexual abuse and what is being done to make sure that it never happens again. Will the Leader of the House make time available for this important issue to be debated?

Andrea Leadsom: The hon. Gentleman raises a very harrowing issue. I think that everyone in this House would want to send their deepest condolences and thoughts to the many victims of that paedophile. Some of the things that have happened to them are appalling. The hon. Gentleman may want to take it up, in the first instance, at Home Office questions next Monday.

Jim Shannon: According to Persecution Relief, an ecumenical focus group, attacks on Christians in India have doubled in the past year  to 736. Worryingly, it has also recorded a growing trend of attackers filing police complaints that accuse Christians of crimes such as sedition or even inviting attacks by offending local people and their religious sentiments. Will the Leader of the House agree to a statement or a debate on that matter?

Andrea Leadsom: The hon. Gentleman raises, as he often does, the issue of religious freedom. He will be pleased to know that there is a Backbench debate on 1 March on freedom of religion or belief, so he will have the opportunity—

Jim Shannon: It’s my debate!

Andrea Leadsom: Okay. I am delighted on the hon. Gentleman’s behalf, and I am sure it will be a great success.

John Bercow: It is very heartening to know that the hon. Gentleman is aware of the fact that the debate is taking place and that it is his. That is a good start.

Jim McMahon: I and a number of other Members have been raising with the Government the 1984 Cammell Laird strike. That campaign is currently undertaken by the GMB trade union. I refer Members to my entry in the Register of Members’ Financial Interests, as a GMB member and sponsored MP. We have been raising that for a year,  including in the House at Justice questions last April and October. We have been waiting for meetings that have now been withdrawn. How on earth can we hold the Government to account when they refuse to answer questions in this place, offer meetings and then withdraw them and have us going round the houses for nearly a year?

Andrea Leadsom: I am sorry that I am unaware of the problem that the hon. Gentleman is raising with the Justice Department, but if he emails me, I can certainly look into that on his behalf.

David Drew: Can we have an urgent debate on the future of the children’s centre network? That was one of the last Labour Government’s proudest achievements, but it has been cut back drastically on the basis that there would be streamlining of the service. In Gloucestershire, we are now facing the potential closure of the few remaining children’s centres. It is vital for the future of our children that we know what provision will be available.

Andrea Leadsom: I am an enormous fan of children’s centres. They were a fantastic initiative and have certainly provided a huge amount of support for children. I am sure the hon. Gentleman will be aware that this Government have invested enormously in nurseries and childcare, enabling many more parents to benefit from up to £5,000 a year of tax-free childcare. More nursery care and qualified childcare is enabling more families to go back to work with the reassurance of knowing that their children are well cared for.

Tony Lloyd: The Leader of the House will be well aware of legislation passed last year to prevent the mass farming of tickets by ticket touts, but when we read that tickets for “Hamilton”, for example, are now being retailed at £6,000, which is absolutely outrageous and ridiculous, is it not time that we had more comprehensive legislation dealing with ticket touting? Can we have an early statement from the relevant Department on that?

Andrea Leadsom: Having tried to get “Hamilton” tickets recently, I know that they are at a premium; I completely agree. The hon. Gentleman seems to offer me some tickets from his inside pocket. He is right that ticket touting is an enormous problem, and I certainly encourage him in the first instance to seek an Adjournment debate, so that he can raise his concerns.

Chris Elmore: My constituent has faced 10 years of harassment and antisocial behaviour due to their neighbours using CCTV to track their movements in and out of their home. The constituent has raised with the police concerns about the surveillance camera code of practice. Will the Leader of the House ask the Home Secretary or a Home Office Minister to make a statement on the code and its success rate five years after it was published by the Government?

Andrea Leadsom: The hon. Gentleman raises a very concerning issue. It must be horrible for his constituent to have to be harassed in that way. He will be aware that there are Home Office questions on Monday, and I encourage him to raise that directly with Ministers.

Anna McMorrin: NatWest bank is 73% publicly owned, and in my constituency, as in other communities across this country, it is closing many of its high street banking facilities. What responsibility do the Government accept for the damage caused to these local communities, and will they hold a debate on that issue and the justification for it?

Andrea Leadsom: I certainly agree with the hon. Lady that access to banking is absolutely vital. She will be aware that banks’ decisions on whether to close are commercial decisions made by them. There is an agreement with the banking sector that they will consult widely and ensure that closures take place only where volumes and footfall justify such a closure. She will also be aware that the Government have invested heavily in the post office network, and that post offices now provide basic banking services for about 98% of all personal and business customers. Those customers can carry out basic banking transactions within the post office network.

Justin Madders: Last year, the Supreme Court ruled that employment tribunal fees were unlawful and that all claimants should receive back their fees as a refund. The latest figures show that only about 6% of people have actually received such refunds, and I am at a loss to understand why that figure is so low, given that the tribunals service has the details of every single person who has made a claim. May we have a statement from the relevant Minister on what the Government will do to make sure that people get back the money to which they are legally entitled?

Andrea Leadsom: The hon. Gentleman raises an important point, which is clearly one for the Ministry of Justice. If he writes to me, I will take it up with the Department, but I encourage him to raise it directly with Ministers at the next Justice oral questions.

Drew Hendry: May we have a statement on the role and responsibilities of the UK Government in supporting families of UK citizens missing abroad? Liam Colgan from Inverness went missing in Hamburg on 10 February. His family are worried that he is injured or suffering from memory loss, and they are very concerned about the level of help they are getting. They are desperate to find him, and they want to bring him home.

Andrea Leadsom: I am really sorry to hear about that. It must be an incredibly worrying time for Liam Colgan’s family, and I am quite sure that they are desperate to hear news of him. I encourage the hon. Gentleman to contact Ministers directly so that he can seek their support.

Layla Moran: Helen & Douglas House hospice in Oxford is having to close one of its two centres due to lack of funding, which means that it cannot now provide end-of-life care for 18 to 35-year-olds. Just under 47,000 people have signed a petition asking the Government to intervene on the closure. May we have a debate on hospice funding so that colleagues can debate this and other hospices?

Andrea Leadsom: I share the hon. Lady’s gratitude to Helen & Douglas House, which delivers amazing end-of-life care not just to her constituents, but to some of mine, and I am a huge enthusiast for the hospice movement.  The hon. Lady will be aware that local NHS commissioners determine the number of NHS funded hospices in their area, but I would like to reassure her that NHS England awarded £11 million for children’s hospices through the children’s hospice grant in 2017-18. She is right to raise this case, and she may well want to seek an Adjournment debate to discuss with a Minister what more can be done.

Nick Smith: Why are the Government dodging the timetabling of Opposition day debates?

Andrea Leadsom: I just do not accept that the Government are dodging anything. Ever since I became Leader of the House of Commons following the general election, we have been absolutely clear that we are providing exactly the right and appropriate number of Opposition days, in accordance with the Standing Orders. We are continuing to do that, and we will continue to abide by the conventions and the Standing Orders of this House.

Paul Sweeney: Many Members will have noted the recent case of Dr Hadiza Bawa-Garba, who was struck off after being convicted of gross negligence and manslaughter, despite its being an evident case of the institutional failure in the NHS that could have an impact on any junior doctor. This has led to an unprecedented loss of confidence in the General Medical Council among the medical profession. Will the Leader of the House call a debate on improving the governance of the GMC so that we can restore confidence in it?

Andrea Leadsom: We were all very concerned to hear about that case. There is obviously a balance between transparency and enabling lessons to be learned from awful outcomes and situations. The hon. Gentleman is absolutely right to raise the case, and I encourage him to take it up directly with Ministers at the next Health and Social Care questions.

Point of Order

Ian Murray: On a point of order, Mr Speaker. I know this issue has been raised with you before, but I wish to raise it now while the Leader of the House is in her place. Many constituents come to Parliament to meet Ministers and raise significant issues. Many of my constituents have to travel from Edinburgh to London, but no facility is in place to assist them with travel expenses. Jennifer Stewart and Robert Ure came to see a Health Minister after my Adjournment debate about their son who is dying of a brain tumour, and they had to come to London at their own expense this week. Is there any mechanism to look at this issue again, so that those constituents who live furthest from London are not disenfranchised from meeting Ministers and participating in that process?

John Bercow: I am grateful to the hon. Gentleman for his point of order, but I am not aware of any current plan to make such provision. However, I have heard what he said, and I am conscious that in a different context the House does provide support—for example, for schoolchildren who visit this place from considerable distances away—and that a subsidy is in place to enable people who might not otherwise come to do so.
Off the top of my head, my sense is that a generalised provision might not find favour among my colleagues on the relevant Committees, and it is likely to be very expensive. However, where there are particular, pressing reasons for someone to come, and where it could be financially prohibitive or cause considerable disadvantage for them to come without assistance, perhaps my colleagues and I could look at that. If the hon. Gentleman is willing to write to me about the matter, I make a commitment that the relevant body in the House, whether that is the Administration Committee, the Finance Committee or, potentially, the House of Commons Commission, will consider the matter. I hope that is helpful and as much as the hon. Gentleman would reasonably expect me to say today. He has raised an important point, and I thank him for doing so.
If there are no further points of order, we come to the first Select Committee statement. The Chair of the Foreign Affairs Committee, who is poised and perched like a panther ready to pounce, will speak on his subject for up to 10 minutes, during which no interventions may be taken. At the conclusion of his statement, the Chair will call Members to put questions on the subject of the statement, and the hon. Gentleman will respond to those in turn. Members can expect to be called only once. Interventions should be questions and should be brief. Front-Bench Members may take part in questions. I call the Chair of the Foreign Affairs Select Committee.

KURDISH ASPIRATIONS AND UK INTERESTS

FOREIGN AFFAIRS COMMITTEE

Select Committee Statement

Thomas Tugendhat: When you do those introductions, Mr Speaker, I keep waiting for you to say “No hesitation, repetition or deviation”, but I am afraid I cannot make that commitment today.
This is the third report by the Foreign Affairs Committee this Parliament, and I am proud to present it to the House. I think it addresses an important aspect of our foreign policy that, sadly, has often been overlooked by the United Kingdom for many years: the aspiration of the Kurdish people.
Britain has a long and historic connection to the Kurdish people that goes back well over a century. Our relationship with them during our period of governing Iraq, and later with the air policing role that we conducted over Iraq in the ‘90s, demonstrates that we have recognised and on many occasions had an appropriate commitment to the Kurdish people. That is made particularly relevant by Turkey’s recent attacks on Kurdish positions near Afrin, which in recent weeks have been deeply concerning. Those attacks are a continuation of a long struggle between Ankara and the various Kurdish groups, but they are also a new departure. On one side is NATO’s second largest army, and on the other, a militia that is backed by the alliance’s largest.
Those recent events have highlighted the relevance of the Committee’s work, and I thank all those who were key to this inquiry, especially all right hon. and hon. Members of the Committee. Those included—they deserve a mention—my hon. Friends the Members for Wealden (Ms Ghani) and for Stratford-on-Avon (Nadhim Zahawi). Their elevation to ministerial greatness has removed them from citation in the report, but they were very important to many elements of its production and it would be wrong to overlook their contributions.
Our inquiry considered the aftermath of the war against Daesh, during which those fighting the extremists shared an enemy but often held competing visions for what should follow its defeat. Kurdish groups were among those fighting ISIS in Iraq and Syria. They played their part in the military victory and were supported by a global coalition, including us here in the United Kingdom. Their success led them to significantly expand their territory in both countries. That expansion has, in turn, raised tensions with regional Governments. In October last year, after Iraqi Kurds held a referendum that voted in favour of independence, the federal forces re-took most of the territory that the Kurds had taken off ISIS. In January, Turkey began the ongoing offensive against predominantly Kurdish forces in the Afrin region of northern Syria. Our report warned that new fighting, or a complication of the conflicts already under way, was indeed probable and the Kurdish elements empowered by the war against Daesh are likely to be involved. Yesterday’s victories risk causing tomorrow’s wars.
These tensions have pitted some of the UK’s leading allies against each other, not only the Turks and the Americans, who are so intimately involved on both sides, but the forces on the ground. Moreover, they have caused new suffering for the people of the regions, whose severe  humanitarian situation the UK has worked with partners to relieve. They have given another cause for fighting in the region, whose instability threatens the United Kingdom through a proliferation of weapons and violent ideologies. The Kurdish groups told us that they shared the democratic and inclusive values of the United Kingdom, but national Governments frequently described those Kurdish groups as a danger to the region. The United Kingdom’s military support for the Kurdish fighters opposing ISIS emphasises the stake we have in these conflicts and the role we play in helping to resolve them.
Our report examined the aspirations of specific Kurdish elements in Iraq and Syria, and suggested what the response of the United Kingdom should be. In Iraq, Kurdish elements held a referendum in September 2017. They voted overwhelmingly in favour of independence. They did so in the face of opposition from Baghdad, regional states and the international community. They unilaterally included territories that the Kurds had taken from Daesh, but whose governance was disputed by Baghdad. That left them open to accusations of a land-grab.
We praised the work of the Foreign Office in trying to avert the referendum and in seeking to find an alternative way of fulfilling Kurdish aspirations. The FCO told us that, while it could potentially accept any outcome—including independence for the Kurds—that was negotiated consensually with the Government of Iraq, its preference would be for the Kurdistan region to remain in a united Iraq. But the overwhelming vote in favour of independence showed deep frustration and dissatisfaction with the region’s place in Iraq. Many Kurds feel imprisoned in a country that they see as not implementing its commitments of equality to them.
The deep differences between the sides have raised the risk of war. We recommended that the FCO should write to the Government of Iraq, formally offering itself in an enhanced role of facilitating dialogue. We asked that it be prepared to criticise both sides when criticism was due, because it had little to say to us about some of the issues underpinning the tensions. We said that the FCO should press the Government of Iraq to lift the restrictions placed on the Kurdistan region of Iraq after the referendum, most notably on air travel. It should also set out its assessment of the role of Shi’a militias in the reacquisition of the disputed territories, and whether reports of crimes being committed by them are credible. It should explain whether it sees Iran as supporting or controlling the militias. For the Kurdistan region, the FCO should speak out against signs of corruption, the monopolisation of power or the curtailment of democracy. It should encourage political reform and economic diversification. These are issues that affect the whole of Iraq, undermining its reconstruction and threatening the viability of its future as a diverse but united country.
For Syria, our report focused on the People’s Protection Units—the so-called YPG—the armed group that is the target of Turkey’s current operation in Afrin. Its role as the armed wing of the Democratic Union party—the PYD—means that the two are often referred to as the PYD/YPG, a single, predominantly Kurdish entity. Since 2015, it has operated as part of a coalition called the Syrian Democratic Forces, or—ready for another one?—the SDF. The SDF includes non-Kurdish elements, but the PYD/YPG is the pre-eminent component.
Behind these TLAs—sorry, I mean three-letter acronyms —lie significant policy challenges with deep implications for the United Kingdom. The YPG, PYD and SDF are not just names—or letters—but an armed force and a political project that now encompasses more than a quarter of Syria. Their rise to that position was rapid, occurring in just over four years, as they led to the defeat of ISIS on the ground. That defeat was achieved with military support from the UK, the United States and others. The Americans provided weapons to the SDF and the YPG. The UK Government say they did not, but the RAF did carry out airstrikes to clear ISIS from its way. As such, we concluded that the expansion of the same group that Turkey is now attacking was likely assisted by the UK.
The PYD says that it does not seek independence from Syria, but it has helped to declare and administer a self-governing region in the areas of the country it now controls. The group described this region as being based on values of democracy and inclusivity that the UK should support, but Turkey’s account of the group and its self-declared region could not be more different. This leaves the UK caught between its two leading NATO allies. The US sees the SDF, of which the YPG is the main part, as its leading local ally against Daesh, but Turkey regards the YPG not only as an abuser of human rights but as an extension of the Kurdistan Workers’ party, or PKK. It therefore sees the PYD and the YPG as a threat to its national security.
We asked the Foreign Office to explain its position and policy regarding the serious differences in approach between two of the UK’s leading allies. Like Turkey, the UK defines the PKK as a terrorist organisation; unlike Turkey, it does not apply that designation to the PYD or YPG. The evidence to our inquiry clearly argued that these organisations were linked, with the nature and extent of those links being debatable—some claimed they were remote, others that they were indeed the same organisation. The FCO’s view, however, was incoherent. Its statements referred to reported links between them, as though it had no clear view of its own, which is simply not credible. The UK is providing military might to one party in this conflict, and the Foreign Office should be clear on the nature of the group receiving military air support. It cannot have a clear policy unless it has a clear view on this fundamental dispute.
The extent to which the UK engages diplomatically with the PYD and supports the group’s inclusion in the Geneva peace talks will have deep implications for relations with the UK’s leading allies in the region. It will also have implications for whether a negotiated end can be brought to Syria’s conflict or whether the war will become yet more complicated and prolonged. Having supported the SDF, and therefore the YPG, militarily during the war against Daesh, the Foreign Office should now clarify whether it will continue to do so and whether it will engage diplomatically with the territory that the UK has helped the group to win.

Ian Murray: I pay tribute to the Chair of the Foreign Affairs Committee. The events in Afrin kicked off only very late into our inquiry and so get only a fleeting mention in the report. Will he tell the House, therefore, what he thinks the Foreign Office should be doing to try to resolve that dispute between Turkey and northern Syria, and how can it help to get the Geneva peace talks back on track?

Thomas Tugendhat: I welcome the contribution of my hon. Friend, which he is, to the report—it was a full Committee effort to which everyone contributed enormously—and thank him for reminding me of an area I have not covered. The Foreign Office, of course, has an important role to play. We have supported one of the parties militarily and are an extremely close ally of the Turkish Republic. It is incumbent on us and our excellent Foreign Office staff in the region to seek to help that dialogue progress. Only through dialogue can this conflict be ended and a peace process begun, and Her Majesty’s Government are extremely well placed to make sure that happens.

Harriett Baldwin: I put on record our thanks to the Committee for its hard work in preparing the report. Thanks to you, Mr Deputy Speaker, and the team, the statement has come to the Floor of the House. I thank you for ensuring that that has happened—it is both timely and extremely informative. I reassure the Chair of the Foreign Affairs Committee that I will pass on the comments made by him and others to the Foreign Secretary and my right hon. Friend the Minister for the Middle East, and that the Foreign Office commits to responding to the report in due course.

Thomas Tugendhat: I welcome the Minister’s words. Very few of us here do not respect enormously the work of the Minister for the Middle East. His work, influence and knowledge of the region is second to none.

David Drew: Is it not about time that we made stronger representations through the NATO Parliamentary Assembly that one of our allies is spending huge resource in attacking potentially one of our other allies in the battle against Daesh?

Thomas Tugendhat: I very much welcome the NATO Parliamentary Assembly’s work, and the hon. Gentleman is right that that is an excellent forum for discussion. However, I should say that the Turkish Government have not only the right, but the duty to protect their population against terrorist attacks and, if they feel threatened, it is incumbent on them to take action. I would much rather see both parties separating, so that we do not see conflict and the peace process can begin, with different groups not engaged in immediate battles.

Philip Hollobone: I praise my hon. Friend for his statement and commend his Committee for its report. He is setting a very good example to other Chairs of Select Committees, who really ought to come to the House on Thursdays to present their reports. Is not the truth about the Kurds that British foreign policy towards them has been wrong for about 100 years? They were abandoned by us in 1918, we ignored them in the treaty of Versailles, and the problem has persisted ever since. Is it not true that, without the Kurds, ISIS would not have been defeated? We now face the extraordinary scenario where the Assad regime is backing the Kurds against the Turks in northern Syria. Given the fact that Turkey has an enormous border with Syria, will this not be an enormous problem for the international community to solve?

Thomas Tugendhat: I am extremely grateful for my hon. Friend’s kind words. I have been clear since the time that I was elected to chair the Committee that I answer to the whole House, not just the Committee. I therefore  feel that it is my responsibility and not a choice—it is simply a duty—to respond to the House and to be available to respond on anything that we have covered.
My hon. Friend is absolutely right: Britain’s history has not been good. We must not forget the air policing, as it was then called. The then Colonial Secretary, one Winston Churchill, was the first person to use chemical weapons against the Kurds. Indeed, it was the RAF that dropped them. One reason that the RAF still exists is that it cut the cost of colonial policing by reducing the number of battalions required. I am afraid that that is true—we do not always have a glorious history.
The truth is that our role today is as a peacemaker and as an engaged friend of the whole region. In that, we should recognise that the Kurdish people have the right to self-determination, and we do recognise that, but we should encourage them to stay as part of the Republic of Iraq in the areas where they are within Iraq. Many witnesses we spoke to said that, although the referendum had called for independence, they were looking for greater autonomy within the Republic of Iraq, so there is more tension within the Kurdish position than appears immediately obvious. It is, of course, a tragedy that Syria remains governed by such a barbarous dictator and it is a great shame that he is being supported by so many around the world. The fact that he is now supporting Kurds to take on another NATO ally does not make us any happier.

Jim Shannon: I congratulate the Chair of the Committee and its members for their comprehensive report. On page 5, paragraph 3, it states:
“The evidence given to us was clear: future conflicts were probable, and Kurdish groups would likely be involved.”
Political events in Kurdistan-controlled areas and Turkey’s interactions have clearly cast a spell over the whole area. Did the Committee consider that Kurdish regional autonomy may be obstructed by Turkey, which is very obvious? However, is it possible that Iraq and Syria may consider it an option? Is it too late to give the Kurdish people the hope, vision and goal that they seek and deserve? Is it possible to move Kurdish regional autonomy from being aspirational to being practical?

Thomas Tugendhat: Part of the evidence that we received was that Kurdish regional autonomy has been a matter of great debate even within the Kurdistan region itself, and it is not absolutely clear that full independence is sought. There has been an enormous amount of debate about that and indeed some evidence pointed to the fact that greater autonomy in the Republic of Iraq was indeed what most were looking for. We did not look specifically into further details of that, so I will not go much further. I merely repeat that supporting the autonomy of the people of the Kurdish region is important, but so is supporting the Iraqi Government’s right to territorial integrity.

Lindsay Hoyle: We now come to the second Select Committee statement. Robert Neill will speak on this subject for up to 10 minutes, during which no interventions may be taken, and I shall then call Members to ask him questions in the usual way. I call the Chair of the Justice Committee, Robert Neill.

HMP Liverpool

JUSTICE COMMITTEE

Select Committee statement

Bob Neill: This report results from what was described by Her Majesty’s chief inspector of prisons as one of the worst inspection reports of a prison that he had ever seen. It was certainly the worst inspection report that our Committee had ever seen and, because of the gravity of the situation, we took the unique step of holding a specific evidence session on that individual inquiry. It highlighted conditions at Liverpool prison that the chief inspector described as “squalid”, a history of deterioration over a two-year period, and a history of management failure at local, national and regional level over time. It also highlighted a number of systemic problems that we believe need to be addressed by the Ministry of Justice and Her Majesty’s Prison and Probation Service, and the need for approaching afresh the way in which we deal with Her Majesty’s inspectorate of prisons itself.
I pay tribute to my Committee colleagues, a number of whom are present today, for their work on this report, and I also welcome the Minister to his place. I particularly appreciated that he came to give evidence to our inquiry so early on after being appointed to the post in which he now serves.
I will briefly give an outline of the report against that grave background. Liverpool prison was inspected in 2015, and it was failing then. It was re-inspected in 2017, and it had got worse. Some of the conditions—a man with mental health problems was in a cell that was not fit for habitation; there was a serious maintenance backlog, which had doubled from 1,000 to 2,000 over that period; and the prison’s markings against various tests had gone backwards—indicate that there was not only a gross failure of management locally and of regional and national oversight, but that the detailed recommendations of Her Majesty’s inspectorate that were made in 2015 had not properly been addressed. That is the first systemic matter that we deal with.
It is pretty clear that the national leadership was not alert to the situation on the ground. The head of the Prison Service, Mr Spurr, told us that he had been informed by the local management that some 60% of the recommendations in 2015 were on track to be met. That was wrong. In fact, only 25% or so were met, and 60% were not met. The leadership nationally was out of touch. What was the role of the deputy director of corrections, who is supposed to have oversight of 12 prisons in that region? Clearly, there was not just a failure of communication, but a breakdown in how the system operates there.
This is not unique. Her Majesty’s chief inspectorate indicated to us that it is a regular occurrence for its recommendations not to be acted on. The Minister rightly said to us that much greater use should be made of the inspectorate’s recommendations to drive changes in behaviour. He is right. We recommend therefore two specific matters to effect that.
First, at the moment, the Prison Service marks its own homework. That is not satisfactory and it can breed complacency. We therefore recommend that HM inspectorate of prisons be given additional resource so  that it can follow up on the implementation of its recommendations and hold the prisons to account. This is not a large sum in the overall scheme of things; perhaps one inspection team would be sufficient to do that task and probably the overall saving would mean that that would be offset. Secondly, Ministers should take personal responsibility for seeing that inspections reports are acted on and should account to the House for that, perhaps through a letter to the Justice Committee. That is the first of our practical recommendations, which we believe would offer a way forward.
There is also the whole question of the oversight itself. Given that there were these failings, we believe that greater work should be done to ensure the transparency and accountability of the above-establishment teams in the Department. There was also a clear problem with the facilities management contract. Not only had the backlog got worse, but it is pretty clear that basic issues that should have been picked up in the contract were not. The fact that there were rat and cockroach infestations shows the level of the problem. We are not satisfied with the explanations we were given for the failures in that contract and we therefore believe that there is a need for greater transparency, so we recommend that major contracts—this is a national contract with Amey—should be subject to a public framework outlining the expectations, performance and penalties levied against a provider for failure. If there are penalties, there should be a system of naming and shaming, frankly. There should be a public notification of where failures occur and how much of a penalty is levied against the provider as a percentage of the contract. That is the whole point of outsourcing—to drive changes in behaviour—but we need transparency and openness to do that.
We also noted that part of the problem derives from persistent overcrowding. Liverpool prison was not understaffed—it was up to establishment—but it was nevertheless pressed for numbers. We therefore recommend that the Ministry and the Prison Service publish a plan to resolve the persistent overcrowding of the estate to take some of the pressure off governors. The new governor at Liverpool is clearly doing a very good job under difficult circumstances, but we need an overall plan to deal with overcrowding and that must aim to reduce the prison population and/or increase safe and decent capacity. We cannot have it both ways.
We were also concerned about the poor situation with healthcare that was discovered. We were glad to see commitments from the Prison Service and NHS England to publish a partnership agreement on how they are working together. However, the last partnership agreement expired in April 2017 and the new one will not be in place until 2018. The gap of a year is not satisfactory in that regard and we need steps to be taken to ensure that that does not happen again.
Finally, we need a commitment to ensuring that there is decent healthcare. It was explained to us that the overcrowding and the nature of the regime meant frequently that prisoners could not be brought from their cells to healthcare appointments. We need a much more joined-up approach to that.
Those are the principal recommendations of our report, which I commend to the House. At the end of the day, the decency of a society is judged by how it treats those who offend against it as much as by how it treats those who do well by it. Liverpool failed in that regard.  We did not house prisoners in the decent conditions that common humanity and our international and domestic legal obligations order that we should. That failure cannot be allowed to happen again. Making greater use of the inspectorate and its tools and adopting our recommendations will, I hope, be a constructive way forward in assisting the Minister in what I entirely believe is his intention to get back to getting the basics right and improving the Prison Service. It is in that spirit that we put the report before the House and commend it to the Minister.

Dan Carden: I welcome the Committee’s report and thank the Chair for his quick decision to hold an evidence session specifically on HMP Liverpool following the publication of the original inspectorate report. I further welcome his commitment, as stated here, to hold the Government to account when prisons fail. We have lost another life inside the prison this week. Anthony Paine, 35, who suffered with mental health problems, was found in his cell and died in hospital on Monday.
The report does not mention in detail the failure to invest in infrastructure and renovate wings or the loss and replacement of experienced prison officers and, critically, resources. Having seen the prison with my own eyes, I have no doubt that these are basic but expensive requirements, but in a written answer to me the Minister says that there is no plan to publish the costs or programme of urgent works at HMP Liverpool. Does the hon. Member for Bromley and Chislehurst (Robert Neill) agree that it is vital that we have transparency across our prison network and the improvements that are necessary if we are to see real change?

Bob Neill: I am grateful to the hon. Gentleman. I know that he knows Liverpool Walton jail, as it is often called locally, very well. I entirely understand the point of his remarks and I hope that the Ministry will reflect on that. The whole thrust of our report is that we need to shine the light of transparency and publicity on these matters. We also, in a separate piece of work, have in hand an inquiry into the shape of the prison population by 2020. Part of that, again, is this need to deal with overcrowding. Our recommendation on persistent overcrowding is part of that. Getting the fabric right is necessary. Walton jail—Liverpool prison—is one of the old Victorian prisons and there is a real need for work to be done there. If we are publishing the public framework on facilities maintenance, I do not see why we should not be able to have similar publicity about the capital works that are required.

Rory Stewart: This is an historic opportunity. I think that this is the first time in more than 200 years of our Prison Service that we have had an individual prison debated on the Floor of the House. I pay tribute to the Justice Committee for bringing the matter forward.
The situation in Liverpool prison was, as the Chairman of the Select Committee has pointed out, genuinely shocking. It is very disturbing and it is unbelievably important that Select Committees, inspectors and Members of Parliament hold us accountable for prisoners. These are closed communities. They are often hidden away from the public. In many areas, they can be forgotten, and without scrutiny standards can drop. They dropped very seriously in Liverpool prison.
The condition in the cells was unacceptable, how prisoners were treated was unacceptable, and the lack of purposeful activity was unacceptable. We are now addressing this hard and quickly, but there are still huge lessons to be learned through the system. I pay tribute to the new governor, Pia Sinha, who has come in, taken cells out of commission and made it clear that she has cleaned the prison and that her objective over the next six months is to get those cells into a smart, good condition. We now have the money in place to put in the new windows and she is focused on ensuring that the education and employment activity is good.
More generally, there are lessons right the way through the prison system. We need to get the basics right. There is no point talking about rehabilitation or dealing with reoffending unless we have clean, decent and safe spaces for all prisoners. We want our prisons to be smart and well-functioning. We are bringing in more than 2,000 more prison officers, and that will relieve some of the pressures on the prison estate, but these are new prison officers and will need training and support until they have the prisoncraft to deliver what we require. We also need to invest a lot more in training. Because prisons are unbelievably complex environments, the governor needs the support and training—this could mean months of training—to ensure that they are in a position to turn around the prison. That training should also apply to the uniformed staff. Finally, the role of the inspector and the Select Committee will be vital in improving performance.

Bob Neill: I am grateful to the Minister for that response. He is very much on the case in recognising that we must get basic things: cleanliness, decency, the maintenance of the establishment, and the ability to run a regime where people can get out to healthcare appointments and rehabilitative work. All that is critical. Unless we turn the existing problems around, we will face a real crisis in our prisons.
I look forward to working with the Minister on those matters. In particular, I hope that he will take up our recommendations on the inspectorate and the constructive role that it can play. I can honestly say that this is a case of a small investment being likely to pay off in the long term.

Liz Saville-Roberts: As co-chair of the justice unions and family courts parliamentary group, I welcome the report, but it is amiss that the Justice Committee did not take evidence from unions representing frontline professionals. I understand from the Professional Trades Union for Prison, Correctional and Secure Psychiatric Workers that the maintenance contractor, Amey, refused to undertake pest control at HMP Liverpool, and the previous governor—who was also not called to give evidence—had to use his already hard-pressed budget. I wonder whether the Chair would agree that governors’ autonomy is convenient cover for the Government’s failure to be accountable for the dire condition of the prison estate.

Bob Neill: Let me say first that the Committee engaged with the POA on a number of occasions, and on an ongoing basis. Secondly, the issues relating to facilities maintenance were examined in some detail.  We said in our report that we were not satisfied with the outcomes, and intended to return to the issue. Thirdly, it was specifically not our role to examine the position of the previous governor in terms of the future. We heard evidence from the inspectorate about the position at that stage, and we heard evidence from the current governor about what is happening now, which is an improvement, but we did not think that going into further past history would be constructive. Our recommendations are for ways to try and ensure that this state of affairs does not occur again.

John Howell: One of the most distressing aspects of the report relates to healthcare. My hon. Friend has already spoken briefly about that. Does he feel, as I do, that we can have no confidence in the partnership agreement? One thing that it will not do is get prisoners out of their cells to attend appointments.

Bob Neill: I am particularly grateful to my hon. Friend for his work in the Committee on this and many other reports. He is absolutely right. We are calling for the partnership agreement to be published so that we can examine it, because we cannot be satisfied that it is yet fit for purpose. Previous partnership agreements have broken down, so we need to know how this will be different—in terms of both its structure and the way in which it will operate—in order to be reassured that there will be no repetition of what went wrong in the past.

Tony Lloyd: I congratulate the hon. Gentleman and the Committee on an excellent, timely and important report. However, while it does move us forward, if we are to change our prisons from being simply places of detention in various outrageous conditions to being places where rehabilitation is central—which is what they ought to be—we still have an awfully long journey to travel. Her Majesty’s inspectorate of prisons should be given the resources that it needs for re-inspection, but we also need to be able to establish whether we are delivering the quality of healthcare, education and all the other things that are necessary in prisons that will allow—mainly—our young men to come out and become acceptable citizens.

Bob Neill: I know how closely the hon. Gentleman followed this issue during his time as a police and crime commissioner, and as the interim mayor in his part of the world. He is absolutely right. The report is a useful step forward, but I do not pretend it can be more than that. It has to be part of a systemic change, and I hope that it will help to drive that, but we must think about the systems and about a long-term strategy that relates to the real purpose of our prisons.

Philip Hollobone: I commend my hon. Friend for his statement and his Committee for its report.
When the Care Quality Commission investigates local hospitals and makes recommendations, it returns to those hospitals at a later date to see whether they have been implemented. I do not understand why the same system cannot be introduced for Her Majesty’s inspectorate of prisons.
Is it not extremely alarming that the information given by Liverpool prison to the head of the Prison Service was so inaccurate? Given the speed with which the Committee’s report was produced, will my hon. Friend encourage the Minister to be equally quick in responding to its findings?

Bob Neill: The quick answers are yes, yes, yes and yes. My hon. Friend is right on those points, and I am sure that the Minister will respond quickly. It would be bizarre if recommendations from the Care Quality Commission or Ofsted were ignored in the wholesale way in which those of Her Majesty’s inspectorate of prisons have been ignored in the past, and that absolutely needs to change.

Marie Rimmer: I pay tribute to the Chair of the Justice Committee, which I have recently rejoined. I also pay tribute to the Minister for the quick actions that he has reported. However, we must not forget why we find ourselves in this situation.
I am pleased about the announcement—made some time ago—of the recruitment of an extra 2,500 prison officers, but we must bear in mind that we lost 7,000, so there is still a gap of 4,500. The prison population figures are falling now, but they did go up. The nature of the inmates changed somewhat. The health needs of those imprisoned for historical sexual abuse, for instance, were obviously different from those of the other, existing prisoners, but the budget was not increased to deal with such differences. There has been a drain on resources. At the same time as the loss of the 7,000 prison officers, the drug Spice appeared, and became big business. There were fewer resources with which to manage the inmates, and morale went down with the loss of those prison officers. When recruitment did begin, a baggage handler could be paid more than one of the new recruits. It is important that when we do recruit—and we are recruiting now—those people are trained properly, not for a week but for months. Resources are what is needed. Of course money is important, but there is also the issue of how that money is used. As far as I can see, there has been absolutely no contract management. When I initiated a debate on mental health in prisons, I noted that there appeared to be no communication  between the prisons and the health service. Contracts were awarded and money was given, but there was no monitoring of those contracts.
As the Justice Committee said, and as its Chair has said today, this is about systems and about getting them right. However, it is also about resources. It is about recruiting the right people, training and valuing them.

Bob Neill: I welcome the hon. Lady—in fact, I will call her my hon. Friend, because that is what she is—back to the Committee. I am very glad that she is with us once more.
It is true that we must look at all the issues. There is no single silver bullet. We need a comprehensive plan, and I urge the Government to work on that. I take the Minister’s assurances at face value, because I believe that he does have a desire to achieve what is needed. I look forward to working with him, on behalf of the Committee, to ensure that that happens. Staffing, resources, training, morale, the fabric of the establishment, facilities management and proper contract management are all part of the mix that we need to address.

ESTIMATES (LIAISON COMMITTEE RECOMMENDATION)

Motion made, and Question put forthwith (Standing Order No. 145(3)),
That this House agrees with the Report of the Liaison Committee of 21 February:
(1) That a day not later than 18 March be allotted for the consideration of the following Estimates for financial year 2017–18: Ministry of Defence, and Department for Exiting the European Union;
(2) That a further day not later than 18 March be allotted for the consideration of the following Estimates for financial year 2017–18: Ministry of Housing, Communities and Local Government so far as it relates to homelessness, and Department for Transport.—(David Rutley.)
Question agreed to.

BACKBENCH BUSINESS

DISABLED PEOPLE AND ECONOMIC GROWTH

Lindsay Hoyle: I call Dr Lisa Cameron to speak for up to 15 minutes.

Lisa Cameron: I beg to move,
That this House recognises the potential talent pool within the disabled community; notes that there will be an employment gap after the UK leaves the EU and that there is ample opportunity to include disabled workers in economic growth; calls on the Government to act immediately on its commitment to get one million more disabled people into employment by 2027; and further calls on the Government to increase awareness within the business community of the benefits of employing an inclusive workforce.
I pay tribute to the Backbench Business Committee for enabling the debate to take place. I also pay tribute to the many organisations that continuously champion the rights of people with disabilities throughout the United Kingdom. Without their enduring commitment, we would not be debating his important issue today. I pay special tribute to Leonard Cheshire Disability, to Disability Rights UK—which acts as secretariat to the all-party parliamentary group for disability, which I chair—and to the Disability@Work group. That group consists of dedicated academics from Cardiff University, Warwick business school and Cass business school, and it contributed to the APPG’s inquiry report “Ahead of the Arc”. Since commissioning the report, the all-party group for disability has been pressing the Government urgently to address the disability employment gap, and I know the Minister is open and willing to listen to the report’s suggestions.
This Backbench Business Committee debate is a significant step forward in the fight for equal rights for disabled people. To my knowledge, this is the first time that people with disabilities will be debated in the main Chamber with a focus on their abilities and as contributors to our economy, and not just as employees but as entrepreneurs and as business leaders.

Mark Tami: Does the hon. Lady agree that many employers need education, particularly about those who suffer from mental health difficulties, as many employers are scared or reluctant to take on somebody as they do not understand some of the issues such people face?

Lisa Cameron: The hon. Gentleman makes an important point, and only yesterday I was contacted by a number of people and organisations reminding me to highlight that very point. People with mental health difficulties, and often people with hidden disabilities or disabilities that are not always apparent, can find it a struggle to explain and raise awareness about their difficulties and the adjustments they require. We need heightened awareness among employers—and in Parliament, too, I would suggest. We must continue along that path to raise awareness, to make sure we can harness the skills and potential of everyone for our economy.
All too often, people with disabilities are portrayed as passive and unwilling to work, but that could not be further from the truth. I want to use this debate to change the narrative. I want to see meaningful action,  rather than research and rhetoric. I want to see a welfare system that treats people with disabilities as a willing and able workforce. I want to see improvements to current access routes and the development of new workplace cultures that reflect a genuine appreciation on the part of employers of the positive contributions that people with disabilities make, and I want to see accredited business schemes that go further than ticking boxes. While I might not be able to cover all of these points in my speech, I know that colleagues across the parties will be passionately advocating similar policy and attitudinal change, which is much needed. I hope the Minister will take on board all Members’ suggestions here today, and that we will make progress moving forward.
I want to start on a positive, uplifting note. I have been greatly heartened over the past few weeks by hearing accounts of disabled entrepreneurs, employees and businesses that are champions of their fields. I would like to share but a few examples.
Hannah Chamberlain is a successful tech entrepreneur who recently won the £30,000 Stelios award for disabled entrepreneurs, which is run in conjunction with Leonard Cheshire Disability, after creating a video diary app that supports people to manage their mental health, called MentalSnapp. The app allows users to record short video diaries, rate their mood and name their feelings. It is an example of innovation at its finest, and I applaud Hannah for creating an app that will help so many.
John Cronin is an entrepreneur and now business leader who owns and runs his own sock company, which has made £1.4 million in its first year. John has Down’s syndrome. He runs the company in conjunction with his father, and is the face of the brand. John is a business leader and manager, and nearly a third of his staff have a disability. John says his social and retail missions go hand in hand. He is a businessman and therefore is looking for good, reliable workers, and he believes the disabled community has a vast, untapped pool of great workers.
A number of larger corporations also understand the benefits of a diverse workforce. Corporations such as Channel 4 and Sainsbury’s are good examples of inclusive employers. Sainsbury’s and Channel 4’s workplace adjustment guides are second to none; both companies choose to focus on positive aspects of making adjustments, rather than their legal duty and minimal requirements to do so. Most importantly, these policies are distributed to all line managers, so everyone is aware of the adjustments they are entitled to, creating an open and inclusive environment and workforce in which both employees and company outputs can thrive. Channel 4 goes a step further by issuing “passports” for employees after receiving a workplace adjustment, so when the employee moves into a new role, or their line manager changes, the “passport” can be referred to and used in all future discussions with new line managers.
There are many other great examples of disabled business owners and entrepreneurs, and of inclusive employers, but I wanted to highlight those three, because each shows that in every corner of our economy, and in every type and size of business, inclusivity should be championed not just for ethical reasons, but because it makes good business and economic sense.

Bambos Charalambous: I thank the hon. Lady for securing the debate and for the  examples she has given of good practices in certain organisations, but is she aware that only 16% of people with autism are in full-time employment and only 32% of autistic adults are in any kind of employment at all? Does she agree that much more needs to be done to close the autism employment gap?

Lisa Cameron: I thank the hon. Gentleman for that important intervention highlighting the autism employment gap, which is far too large—much larger even than the disability employment gap. We must take extra strides to support people with autism into work, because they have great skills and abilities and they will be fantastic contributors to our economy given the appropriate opportunities.

Alex Burghart: I congratulate the hon. Lady on securing this important debate and salute the work she does on the all-party group for disability. I serve on the Select Committee on Work and Pensions and we are currently looking at how employers, work coaches and people with disability can better understand the assistive technology that is emerging. Does the hon. Lady think we can do more to bring those three interested parties together to help people enter and stay in the workforce?

Lisa Cameron: The hon. Gentleman makes an important intervention. I am not a tech buff, but I am always heartened when we can see technology assisting people to achieve their potential and get into work. We need collaboration and to take those issues forward.
Examples of best practice are exactly that: they are examples to aspire to, and, as uplifting as they are, they are not a true reflection of the lived experiences of many disabled people. They do not reflect the systemic problems and barriers faced by many people with disabilities in looking for work or trying to retain it. It is time for Parliament to question why these practices, which move us forward and develop inclusivity, are not more commonplace.
In 2017 Scope published a report that found that one in two people with disabilities had experienced bullying and harassment at work and felt they could no longer take part in the workplace comfortably, and over half—58%—felt at risk of losing their job. So this is not just about getting people into work; it is about ensuring there is an environment that maintains people in work and helps them to aspire to and achieve their potential. Disabled people also have to apply for more jobs than non-disabled people before finding one; research shows that almost 60% more jobs have to be applied for. Lauren Pitt reported to The Independent in 2017 that she had to apply for over 250 jobs before securing one, so something is clearly not working correctly. We must ensure that employers are open to employing people with disabilities, and to seeing their skills, abilities and value to the workplace and the economy.
The disability employment gap is large and enduring. The most recent figures from 2017 show that the gap currently stands at 31.4%. About 80% of non-disabled people of working age are in work, but the figure for people with disabilities is just 49%. This has been routinely recognised by the Government, and in their 2015 manifesto the Conservatives committed to halving the gap. However, research from the all-party parliamentary group for  disability shows that, on the basis of progress to September 2016, that would have taken 49 years to achieve. Their 2017 manifesto replaced that commitment with a new commitment to get 1 million more disabled people into work in the next 10 years. Analysis suggests that this new target is weaker and is likely to be met simply because the number of disabled people within the working-age population is increasing. That means that even though the Government might well meet their new target, the size of the disability employment gap might not actually shrink. We must take account of that.
Most of the Government’s proposals for reaching their more attainable commitment are published in the Command Paper “Improving Lives”. A brief look at the paper shows that almost all the policies are dependent on further research or pilot schemes and cost very little to run, so I would ask that we have adequate resourcing and prioritisation. We cannot afford to sit and wait. Unemployed people with disabilities are entitled to the same opportunities as everyone else—now. Our economy cannot afford to sit and wait either. Scope has estimated that reducing the disability employment gap by just 10% would generate a further £12 billion for the Exchequer by 2030, so it makes absolute economic sense.
Finding a solution to the problem will involve going significantly beyond the Government’s current focus on welfare and benefits. We will not see significant increases in the number of disabled people in employment unless employers can be encouraged to up their game, to acknowledge the positive contribution that people with disabilities make in the workplace, and to develop new workplace cultures and practices that are more accommodating. Reasonable adjustments are key.

Alex Burghart: I support what the hon. Lady is saying about businesses. Does she think that there could be a case for having larger employers report on the proportion of their workforce who have a disability, so that we could see which large employers were not pulling their weight and not taking advantage of the high-quality disabled employees who are in the market?

Lisa Cameron: I agree entirely with the hon. Gentleman on that point. It is particularly concerning that the Office for National Statistics has suspended publication of disability statistics from the labour force survey. We should ensure that that matter is addressed.
It is in employers’ self-interest to make a difference in this area, not least because it presents a solution to the labour market problems that this country is likely to face in the event of tighter controls on the free movement of people. The UK currently has a skills shortage, and it will become more profound once we leave the European Union. Indeed, KPMG recently published figures indicating that almost 1 million EU citizens, many of whom are highly qualified, are planning to leave following Brexit. We already have a willing workforce of people with disabilities whose skills are undervalued, and they should be trained in sectors that are developing and that will be much needed in the future. As has been mentioned, the health and tech sectors are extremely important.
This is fundamentally a labour supply issue. The Government will not be able to deliver on their industrial strategy if they do not have the capacity to do so, so we need to train our ready-and-waiting workforces across the UK. We need to see more investment in apprenticeships,  as well as the targeted, widespread advertisement of current Access to Work schemes, to encourage the business community to utilise our workforce. The new commitment in the industrial strategy to increase the proportion of apprenticeships started by people with disabilities by 20% is an excellent start, and I commend the Minister for that, but it is not enough. It will form only part of the solution.
The Government acknowledge this critical role for employers, but their main policy in this area is to encourage more employers to sign up to the Disability Confident scheme. As I have argued previously in Parliament, the evidence on Disability Confident is varied. It shows that the scheme does not go far enough, and that it does not result in enough people being employed. It is particularly worrying, therefore, that the “Improving Lives” Command Paper uses the scheme as one of its central policies for achieving the Government’s target.
The all-party parliamentary group’s “Ahead of the Arc” report sets out a number of bold new alternative policy initiatives that the Government should pursue. These include using public procurement contracts as leverage by stipulating that such contracts will only go to firms that monitor disabled people’s employment and commit to adopting an inclusive approach to their recruitment and retention policies. To that end, Government initiatives should think of people with disabilities not just as employees but as entrepreneurs and business leaders. The Government must ensure that disabled entrepreneurs receive the support they need from business advisory networks such as the Federation of Small Businesses and local chambers of commerce, as well as the financial support they need from bodies such as Innovate UK and the British Business Bank.
I referred earlier to two great examples of disabled entrepreneurs. The notion that disabled people can be business owners and entrepreneurs as well as employees was completely missed by the “Improving Lives” paper. We must ensure that disabled people are not pigeonholed into one sector, and that they have the opportunity to choose their own future and be masters of their own lives. That is why the Access to Work scheme should also apply to start-ups, to accommodate the talent and innovation of people with disabilities. The Government must also go further and fund specialist advice services on taxation and benefits for people with disabilities who want to explore the opportunities of self-employment.
As I have laid out today, the solutions are there in every corner of the economy, and if action is taken, the benefits could be felt by all in society immediately. But for this to happen, we need to change the current narrative and put good policy into practice so that my constituents and those of other hon. Members throughout the land recognise that we need to tap into the under-utilised and important human resource of people with disabilities who are willing and able to work. The workforce are there and ready to fill the skills gap that will only grow once we leave the European Union. It is in the self-interest of employers and the Government to engage with this agenda and accommodate a diverse and inclusive workforce, but the reality is that far too many disabled people are facing no real prospects in today’s job market. That is simply unsustainable and, quite frankly, bad economics. I am pleased to have been able to bring this debate to  the Chamber today, and I look forward to hearing other colleagues’ experiences. I also look forward to working together as part of the all-party parliamentary group for disability, and across the House, to take this extremely important issue forward.

Julia Lopez: Thank you for calling me to speak, Mr Deputy Speaker. I shall try to be better behaved today. I am truly grateful to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for leading this afternoon’s debate, for the tone that she has struck and for her constructive ideas. This follows a valuable Westminster Hall debate led by my hon. Friend the Member for Ochil and South Perthshire (Luke Graham) on the Government’s Disability Confident scheme, to which she also made a thoughtful contribution. During that debate, Members highlighted some of the economic opportunities that would result if we increased the participation of disabled people in the workplace. We also focused on barriers to employment, the disability employment gap and the Access to Work scheme. I shall therefore not go into those subjects again, beyond suggesting that the disability employment gap is an issue every bit as urgent as other workforce diversity challenges. Insofar as it results from a lack of employer awareness of the support available, we as MPs ought to take the lead in publicising the Government assistance offered. In that vein, I have now signed up as a Disability Confident employer, and I have discussed with my local jobcentre the possibility of offering a work placement for local disabled jobseekers with an interest in politics.
This afternoon, however, I wish to focus on the economic cost that we will face if we fail to unlock the potential of disabled people of all ages, as well as on the economic power of disabled people both as an active consumer group and as a motivation to develop new assistive technologies with broader application to our growing elderly population. I have previously highlighted the cases of two autistic constituents who desperately want to work but who struggle with the initial stage of any new job. In the past few weeks, I have met the families of autistic children who believe that we must focus our attention on earlier support and intervention. I recently visited First Step, a local charity that provides intensive developmental support to pre-school children. It can be an enormous shock to parents to discover that their child has a disability, and First Step assists not only with the child’s development, but in supporting parents in a non-judgmental environment. Caring for a child with disabilities can place a huge financial strain on a family, particularly if parents need to take time off work or do not have the right support network in place. However, as one local parent said:
“A failure to develop a child is not only a moral mistake, it is also a very expensive financial one. With proper, dedicated support these children could learn to talk and make a decent contribution to society. With no support, they will be left in adult day care centres or worse.”
Too often, local authority support is either entirely absent or limited and patchy. Early investment in the development and schooling of disabled children can lift the strain on parents, helping them return to the workplace, but it also increases the chances of economic participation when a child reaches adulthood and reduces the need for costly adult services later in life.
We also need to continue the steady improvements in accessibility to our transport system. The less daunting it is to leave the home, the more disabled people will be able to participate in the economy by working and spending. I commend the Government for their “Access for All” scheme, I support the Changing Places campaign, and I would be grateful if the Minister applied pressure on the Mayor of London to prioritise transport accessibility and facilities for disabled Londoners. Last week, Mr Khan found £6 million for new toilets for bus drivers. I wonder if he might make those facilities available to disabled transport users and also improve lift access to the District line, which runs through my constituency and is one of the most practical routes for disabled users to access.
With the advent of new assistive technologies, there is greater scope than ever for disabled people to contribute to growth, as well as colossal opportunities for UK tech and medical firms. As the Financial Times suggested in a recent article, 1 billion people across the world
“have some form of disability. As people live longer, often with conditions that reduce their ability to use their hands or to co-ordinate, the market will grow sharply. Accessibility makes good business sense”.
British businesses are developing more sophisticated prosthetic limbs, accelerating stem cell technology, improving websites for disabled consumers, and building the Canute, which is like a braille Kindle for blind readers. Such technologies will be vital not just to quality of life, but to making it easier for disabled people to participate fully in the workplace.
In recent years, disability sport has been critical in changing perceptions of those with disabilities, and I hope that technological developments will continue that positive trajectory. Our role as politicians must be to create an environment that not only facilitates technological development, but embeds it in everything we do—whether that is the setting of new buildings standards, the design of public buildings and information delivery, or the integration of public services with technology. I shall be most grateful to the Minister if she will update the House on how the Government are encouraging accessibility and nurturing firms and charities that are developing assistive technologies, and I would appreciate her views on the points raised about the importance of early investment and transport.

Stephen Lloyd: I pay tribute to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), the chair of the all-party parliamentary group for disability. I have been working on this issue on and off for over 20 years, so it is interesting that, despite all the efforts made by many people over the years, we still have just under 4 million people with disabilities who are called economically inactive, which means that they are of working age but not employed.
There has been some progress, however, and I remember working with others many years ago to support the then Conservative Prime Minister John Major in getting the Disability Discrimination Act 1995 passed. The DDA was an absolute game-changer and created a regulatory framework to ensure that people could not discriminate against disabled people in goods and services or in employment. The reason why that was such a game-changer is that disability discrimination is rather peculiar in that  it is quite often tacit, quiet or nuanced. It could be what I call the “poor you” model. People may say, “You poor, brave disabled person. Here, have a benefit and do not worry about working.” We do not mean to do that—it is partly based on human nature and partly on a lack of understanding—but it can be incredibly difficult to break through. It was that way many years ago, and it can still be like that, albeit there has been some progress over the years.
The DDA worked well around goods and services. For example, if I have a restaurant and do not put a ramp outside, the disabled person in a wheelchair who cannot get in can sue me. It is very straightforward, and the situation is easy to fix. There may be cost implications, but most businesses got over that quickly and, as the chair of the APPG will know, when a business makes itself accessible, it often makes more than enough money to pay for the costs of improving accessibility.
Things are much harder, though, with employment, particularly if someone who is disabled is applying for job. If someone works for a company and acquires a disability, the DDA and broader knowledge in general mean that businesses, whether in the public sector or the private sector, are much more likely to make the necessary effort to keep them in a job. It is much harder for someone with a disability—they could be blind, visually impaired, deaf or have autism—to get over the threshold and get a job. I struggled with that issue many years ago with some good disability consultants, and I will mention them in the House because they have done so much over the years: Phil Friend, Simon Minty, and James Partridge, a former chief executive of Changing Faces, which is a charity for those with a facial disfigurement. The four of us worked for many years in this area with the Business Disability Forum to try to break through, and it was difficult.
After losing my seat at the 2015 election, I went away and have now come back, and the APPG is still going great guns under the hon. Member for East Kilbride, Strathaven and Lesmahagow. However, when I read the Government’s “Improving lives” report, I still feel a little downhearted, which is not my nature. Anyone who is a Liberal and downhearted is in the wrong party, because we need to be optimistic, but progress is hard. However, I want to offer a little story of when things work, which can be game-changing for both disabled people and businesses. About 10 years ago, I was working with one of the big utility companies, and it had a large call centre in north London. I am sure that Members know that the turnover in call centres is always high, because it is a difficult job. The utility company had about 100 staff and, along with several others, I worked with the company to persuade it to take on 15 people with disabilities as call centre agents. It was hard work but, to give the company its due, it did agree.
As I said earlier, the difficulty is not about people being anti-disabled; it is about fear, anxiety and people not knowing how to deal with circumstances that they do not understand. People often just lift the carpet and sweep people with disabilities under it, which I have always found frustrating. It makes me angry, and I know that other Members share that view.
Going back to the call centre, the company did finally agree, we found the right number of disabled staff to be interviewed, and 15 or so were hired. A year later, 14 of them were still there. Two years later, there were still  14 there. The point is that one of the fundamental advantages of hiring disabled staff is that they are often much more reliable than non-disabled staff for several different reasons, some of which are plainly evident. That makes the business case for hiring disabled people very strong, but they will need some guidance and support, not least because of their disability. My disability is hearing loss, so I need an induction loop, which I use in the Chamber, and a phone with a special volume control. It is just a matter of providing the right facilities, which is where Access to Work often comes in, to allow disabled people to shine.
Quiet discrimination is the much bigger issue. Disabled people may be viewed as not really capable, or employers may not know how to deal with a situation, so they may again sweep such things under the carpet. All those sorts of things are incredibly difficult to change, so where are we at? The Government’s Green Paper on improving lives was good because it highlighted some of the figures: 3.7 million disabled people are economically inactive. Another figure I have read is that if 1% of disabled employment and support allowance claimants gain employment, it would save the Exchequer £250 million and boost the economy by a further £260 million—that is £0.5 billion—which seems an awful lot of money from making an extra little effort to help people get jobs.
Every Government face disability challenges. It is hard for people to get back into work if they have been out of work for many years but, with the right levels of support, work is transformational for those individuals and families. A 2016 report by the Joseph Rowntree Foundation found that half of all households in poverty have at least one disabled member.
One of the reasons why many of us are MPs is that we know that helping people to get a job breaks the cycle of poverty, and that is certainly one of the main reasons why I got involved in politics. It just takes something focused. It is not enough just to say well-meaning things. I have been involved in this for years, probably more than anyone in the House, and well-meaning is not enough; regulation is needed.
I am tremendously appreciative of the fact that the Conservative Prime Minister John Major and his Government introduced the DDA—I do not often stand up in the House and compliment Conservatives—because it forced people to change. People with emotional attitudes often do not realise that they could be wrong or that they could be discriminating, which is why, even as a Liberal, there are certain times when I believe that we need to legislate. The DDA was one, and seatbelts was another. I am old enough to remember the uproar when seatbelts became compulsory—people said it was the end of the world as we know it. What happened is that people had to wear a seatbelt, and they got busted by the law if they did not. Since then, as we all know, the number of people dying in car accidents has plummeted. It is the same with disability.
What needs to be done now, further to the DDA? All these years later, we still have not made enough progress. There need to be specific incentives for businesses to recruit disabled people. As the hon. Member for East Kilbride, Strathaven and Lesmahagow mentioned, there needs to be specific action on procurement. We need to  be that prescriptive to break the logjam. The need is greater than ever because with Brexit, whatever side of the divide we sit on, we know that there will be substantial staff shortages over the coming years. In fact, a recent report identified that there will be 32 areas of staff shortages in tier 2 occupations. It has become ever more relevant to try to square this circle.
I will not let the Government off the hook completely. It was not the decision of the current Disabilities Minister—this is not personal—but this Government’s decision to change the work-related activity group of ESA so that people receive a lot less money is foolish and short-sighted. There are three areas of ESA: the support group, which is for people with a disability such that they cannot work; basic ESA, at the front end; and, in the middle, for many years there has been WRAG.
WRAG recognises that a claimant has a disability and pays them a bit of extra money, above and beyond the normal jobseeker’s allowance, because those claimants face extra costs due to their disability, but WRAG also recognises that those claimants are ready to work with support. That is really important, because it got people into the frame of mind of being ready to take a risk and leave the structure of the support group of ESA.
After the coalition, after the Liberals were defenestrated, George Osborne quickly cut WRAG by 30%. I was really depressed about it when the change came into effect in April 2017, because I knew what would happen. It is human nature. We should never underestimate the strength of fear for a person in the support group who has been disabled for years and who has been outside work but who is ready, with a little encouragement, to step into WRAG and to try to go for a job.
If I were that person, having been promptly told that my allowance is being cut by 30%, I would do whatever it takes to stay in the support group, because that is human nature. It is not rocket science. It is not bad. It is what people would do. It is what I would do. Even someone as intrepid as you, Mr Deputy Speaker, would do it because at least they would then be secure, with money for the roof over their head, for their children, for food and the rest. Reducing WRAG was such a foolish idea, and I am bitterly disappointed that the Government did it. It is a classic case of the Government cutting off their nose to spite their face.
Since being re-elected, I have had shedloads of post from disabled people trying frantically to get back into the support group, and I am supporting them. I would like the Minister to address that, and perhaps to take back to the Chancellor the fact that reducing WRAG was a bad idea. Perhaps we can change it.
Finally, where are we at? Again, I am grateful to the hon. Member for East Kilbride, Strathaven and Lesmahagow for securing this important debate that affects hundreds of thousands of people across the country. There is not an MP in this House who does not have hundreds, if not thousands, of disabled constituents. This is so important, as we know from our casework and from how many people with disabilities come to see us for help and support.
I would love to see this Government, or a Government, step up and do a DDA part 2 on employment that says businesses, the private and public sectors, organisations and charities across the piece have to do x to employ x number of disabled people, or at least to show that  they have systems and processes and that they have interviewed the requisite number of people with disabilities for every job. I do not want it to be tokenistic, as a lot of people with disabilities have tremendous skills—they just need the opportunity. If that happens, it will transform the employment opportunities for disabled people and it will transform many millions of families living in poverty in which one or both parents are disabled. It will be the game changer that this nation deserves, and it might just possibly be something positive to come out of Brexit.

Bim Afolami: I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this Backbench Business debate. I also pay tribute to my hon. Friend the Member for Hornchurch and Upminster (Julia Lopez), who is not just an hon. Friend but an actual friend.

Lindsay Hoyle: We are all friends.

Bim Afolami: We are all friends. My hon. Friend the Member for Hornchurch and Upminster made a powerful speech and stole at least half the things I was going to say.
People often ask, “Why did you go into politics?” I am sure we are all asked that, and we all have many reasons for going into politics, not just one. The most important reason I am in politics is to enable everybody to use their God-given talents, whatever they are, in the best way they can to contribute for themselves, for their family, for society and for the country. That is why I am in politics. People with disabilities are fully included in that, which is why this debate and this subject are of critical importance.
There will be those who say that many disability benefits should be more generous, and in some ways they probably should be. I know that the Minister, who truly and strongly believes in this brief, and Treasury Ministers will always do whatever they can to make sure appropriate resources are in place to help those who need them. But let us not kid ourselves. The subject of this debate is economic growth. What is important for people’s well-being and their lives is the opportunity to make the most of themselves in a professional, work, career capacity. That is crucial. Although benefits are important, we also need to do everything we can to get everybody who has a disability into appropriate work, where possible. That is what I regard as the heart of social mobility.
We often talk about social mobility in this House, in many different ways; we talk about it in debates about education, higher education, the Treasury and the Department for Business, Energy and Industrial Strategy. We talk about it all over the place. The way we usually talk about it is by discussing an individual who has come from a poor background but overcome the odds to achieve something fantastic and get to the top of a profession. We should celebrate that—it is what Britain is about—but social mobility is more fundamental: it is about ensuring that our society uses the skills and innate talents of those with and those without disabilities to their fullest. That is true social mobility. It allows everybody the ability to use their God-given talents and make the most of their lives.
Where are we now from a policy perspective—from a governmental perspective? The Conservative party manifesto in 2017, which I read carefully—that is a good thing for a new candidate to do—stated:
“We will get 1 million more people with disabilities into employment in the next ten years.”
By my calculations we need to raise the number of people with disabilities in employment to about 4.5 million over the next 10 years in order to achieve that target. That would mean a growth of almost 30% on the current level. I think we would all agree in this House that that is a big task. The Government and my party are very focused on that—indeed, I suspect we will find that Members from across the House agree on it.
In November 2017, the Government set out a 10-year plan to improve the situation and to deliver on that manifesto pledge. I am sure the Minister will elucidate further on the plan and where the Government are with it. Its main thrust appeared to be linking up the welfare system, the workplace and healthcare. As has been alluded to in the debate, it was particularly about bringing in new technologies, especially assistive ones, to help to turbocharge the growth we have been gradually seeing, so that people with disabilities can enter the workplace.
A 5% rise in employment among people with disabilities would bring an increase in GDP of £23 billion, with tax revenues up by about £5 billion to £6 billion. That is a considerable amount. Research by Scope, the disabled charity, has found that 58% of disabled people have felt at risk of losing their job because of their impairment or condition. It is clear to me, and probably to most, if not all, Members of this House, that we need to work much more closely and intensively with employers to drive change.
Several decades ago, many employers did not like to employ women. What happened over time was that this House, working with employers and through legislation, helped to drive change. A few decades ago, we did not find people who looked like me or like the Opposition Front Bencher, the hon. Member for Battersea (Marsha De Cordova), in this place or in the other place, and several employers did not like to employ people of ethnic minorities. What happened was that this House, through legislation and by working closely with employers, helped to drive change. Now the time has come for those with disabilities to get much better access to employment opportunities. The Government need to work with employers, along with the legislation that is already in place, to help to drive change.
Disability Confident is a good scheme, which is welcomed generally across the business community, in government and in civil society, but we can go further. The Government should bear in mind the huge gains to be made—not only the economic ones, but the gains in terms of the life chances and economic potential of this huge group of people.
The Government need to work further on two main things to help to drive this change and this turbocharge. The first is to financially incentivise, perhaps through the tax system or in another way, employers to take on more people with disabilities, especially in industries where today they may not typically be found. For that to happen appropriately—businesses tell me this when I have the discussion with them—we need to be able to have a much better understanding of the different  capabilities of different people with disabilities, so that we can make sure that we match the right employment opportunities with the right people. That is critical. If we do that properly, in combination with proper incentives for business, we will be able to see a huge increase in this area.
Once more people with disabilities not only get into the workplace, but progress within it—through promotion and by getting to the top of their businesses—they will show what they can do. They will show what they can contribute. That will send a powerful message, not only to them, to society and to this House, but to the country as a whole.

Jamie Stone: I, too, congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing this debate on an extraordinarily important subject. It is a shame more Members are not here today, but perhaps there are competing things to do. However, we have some of the best here in the Chamber; as Miss Jean Brodie would have said, we can consider ourselves the crème de la crème.
I have a personal interest in this matter, which I make known to the House: my wife has been disabled since 1999, and that has featured large in our lives. As some Members may be aware, once upon a time I was a Member of another place—I do not mean down the Corridor; I mean in Scotland. As my wife was disabled, I quickly realised that the temporary Scottish Parliament at the top of the royal mile was completely unsuitable for anyone who was disabled, which was why I volunteered to serve on the small committee that was given the responsibility of building the new building. We put in place complete disabled access, including in the Chamber of Holyrood itself. That job very nearly cost me my seat at my second election, such was the controversy attached to the Scottish Parliament at the time. But that was then and this is now, and for the record, I must say that I am proud to have been involved in building such a disabled-friendly place.
The hon. Member for East Kilbride, Strathaven and Lesmahagow talked about examples, which are ultra-important. I wish to make two points on that. First, this summer’s May games—one of the northernmost highland games, which the Prince of Wales likes to attend, as Duke of Rothesay, and he will do so again in the summer—will have disabled servicemen taking part in the events for the first time. That is an historic first for the highland games in Scotland and for my part of the world, the far north.
The other example that will stay with me to my dying day involved a former Member of this place, Dame Anne Begg, who graced the Labour Benches for a number of years. I knew Dame Anne because she was in a cross-party group dealing with oil and gas; I was in the Scottish Parliament and she was in Westminster. I will never forget going to visit an oil installation in a fjord in Norway. We were in a semi-open boat with a noisy diesel engine, and Anne was there in her wheelchair. The weather can change very fast in the Atlantic, and in this particular Norwegian fjord, a storm came. The boat was going backwards and forwards, and lashing  about. We had to lash Anne’s wheelchair to a thwart to prevent her from going overboard, but such was her courage and good humour that she never blinked once. That is an example of somebody who is disabled who faced adversity in life and yet got on with things. I will never forget that example of somebody who was very brave indeed. Based on those examples, the ambition is there, and I particularly pay tribute to the hon. Member for Hitchin and Harpenden (Bim Afolami) for bringing that point out; it is hugely important.
Today, my wife volunteers for the local museum in my home town, and she is involved in raising money for Marie Curie. The point is that these unpaid involvements enrich her life; I can assure hon. Members that they make everything much more worth while. If we can broaden these things out into employment, we can see the great gift that can be given.
The points that have been made about taxation and benefits are absolutely right. I was intrigued yesterday. I have an Irish son-in-law, who, perhaps not surprisingly, has the name of Paddy. He came by Westminster yesterday evening in search, I think, of a small refreshment in the Strangers Bar. He asked me what I would be talking about today, and I said it would be this issue of disability and using resources. He said that he is mixed up in a textile business in the Republic of Ireland and that there is a Government incentive scheme to encourage businesses such as the one he works in to employ people in the situation we are talking about. That struck me. I did not get into more detail, but I will do in the future. I think we could learn something from the Republic on that. I sincerely hope we can.
The point has been made by the hon. Members for East Kilbride, Strathaven and Lesmahagow and for Hitchin and Harpenden and by others that we are mugs if we do not utilise the skills, ability, ambition and enthusiasm that is out there. Goodness knows, in the next few years, we are going to have to mobilise everything we have in the UK, because it will be an ever more difficult and competitive world. Be it Brexit or be it remain, that will be the reality, and we will have to use every single person we have to do the best we can. People will relish that opportunity—I have absolutely no doubt about that.
I look forward with great interest to hearing what the Minister has to say. I think we are as one in this Chamber. As a not so new Member now—I have been here seven and a bit months, not unlike the hon. Member for Hitchin and Harpenden—I think that what Westminster does best is get on to issues such as this. I am astonished that this issue has not been debated in the Chamber before, but never mind—here we are today. As I said, to quote Jean Brodie again, we are the crème de la crème.
It is as simple as this: there is a bargain to be struck here. Disabled people are offering to keep their half of the bargain, and it is up to the Government—not just the Government, but all of us in society in the UK—to grasp their hand, honour our half of the bargain and make their lives better.

Michelle Donelan: I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing this important debate.
I am delighted to speak in today’s debate on the role of disabled people in economic growth. Economic growth is built on investment, development and progress but most of all on people. People are the essential building block—manual workers, service workers, foremen or managers, entrepreneurs and innovators, females and males, all ethnicities, and the able bodied and the disabled.
I would like to stress today not only that disabled people should and do play an essential role in economic growth but that the wording of this motion is a little too crude. This is not just about needing disabled people to be in jobs to boost economic growth; most importantly, they deserve the same career opportunities, so this is a question of not just economics but equality.
Only half of working-age people in the UK who are disabled or who have a health condition are in work, while the employment rate for people without disabilities is 80.6%. We must rectify this inequality and ensure that employers see the benefits of diverse workforces and of hiring those who have overcome obstacles. We must empower and assist the disabled so that they have the confidence and the tools to work on an even playing field.
That is why I fully back the Government’s commitment and strategy to get 1 million more disabled people into employment by 2027. I am delighted that 100,000 more people with disabilities were in work last year than in 2016. Working with employers is key to reaching this target, which is why the Government’s pledge to work with industry, alongside improved mental health training for work coaches, is so important.
Disabled people have overcome adversity and challenge and can often offer workplaces essential skills, such as determination. They also generally stay in roles for longer and have lower rates of absenteeism. However, studies show that, still, only half of employers have reported that they recognise the benefits for their organisation of employing somebody with a disability or health condition.
This is therefore about changing attitudes and cultures, especially in certain sectors. For example, the rate of employment for disabled people in science, technology, engineering and maths-related roles is severely low. The problem is twofold. It is about encouraging disabled people to believe they can do these jobs, but, crucially, it is also about ensuring that the jobs exist, so working with employers is essential.
The disability confident scheme, which has been mentioned today in the House, has done great work in this area, helping organisations to improve how they attract, recruit and retain disabled workers. As of 16 November last year, there were 5,359 employers signed up to the scheme, so we need to do work to ensure that more follow. Like many MPs, I am proud to be a disability confident employer.
One of the biggest hurdles in encouraging businesses to hire disabled people is the adaptations needed to their offices. Those hurdles are perceived to be high, as a Mencap review recently highlighted. There is also a lack of awareness that the Equality Act 2010 means that employers are under a statutory duty to make reasonable adjustments. I am keen to hear from the Minister about how we plan to challenge these perceptions and this lack of awareness.
Adapting businesses is also important when a staff member has an accident or becomes ill. Creating a suitable and welcoming environment for them to return  to is essential. In fact, the Centre for Social Justice “Rethinking Disability at Work” report found that the disability employment gap is partly driven by the large number of disabled people who fall out of employment, with one in 10 disabled people in work falling out each year, compared with only one in 20 in the non-disabled work population. Retention is therefore key. That is why I welcome the proposed sophistication of the fit note scheme, which will enable employers to better understand and support their employees’ needs.
It is important to note that there are Access to Work grants that can pay for special equipment, adaptations or support worker services, and I am delighted that these are now being rolled out to the self-employed. However, we need to raise awareness of them. Access to Work grants have been taken up by 25,000 people on average per year, but the figures have stagnated for the last three years, indicating that we really need to promote awareness. In addition, 65% of the grants given are to people aged over 40, implying that we really need to reach a younger age group.
I have spoken a lot about employers, but it is also crucial to give disabled individuals the confidence and support to apply for jobs. Mind stresses the point that physically disabled people also need emotional and mental health support when re-entering the workplace, and it is important not to forget that physical disabilities  and mental health challenges are not mutually  exclusive.

Jamie Stone: Does the hon. Lady agree that a disabled person in rewarding employment could be encouraged or paid to take time to act as a mentor to people who might follow in his or her footsteps, to show how it can be done?

Michelle Donelan: I thank the hon. Gentleman for that excellent point, and I completely agree. Encouraging, inspiring and being role models for other people, and acting as mentors, is a wonderful idea, which we should pursue to encourage more people to have the self-belief and determination to progress their dreams and explore opportunities.
We should not treat physical disabilities and mental disabilities in silos; we need to treat them together to develop the best outcomes. I am delighted that the key focus of the White Paper, “The Future of work, health and disability”, includes that area and the roll-out of personal support packages with the recruitment of 200 community partners, 300 disability employment advisers, 100 small employers advisers and an extra 1,000 places in mental support services.
In conclusion, over the past two years, the disability employment gap has reduced by 1.9%, so we are on the right track. Finding work for an additional 1% of eligible employment and support allowance claimants in 2018-19 would save £240 million and provide a boost to the economy of £260 million. Therefore, getting more people with disabilities into jobs is essential. It would obviously be of great financial benefit to our country, but the main benefit would be to the disabled people themselves, and, in turn, it would make our society more equal. I shall end where I began and stress that it is an issue not just of economics, but of equality.

Jim Shannon: It is always a pleasure to follow the hon. Member for Chippenham (Michelle Donelan), and I thank her for her contribution. I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I hope that I pronounced her constituency correctly. [Interruption.] Ah, almost right. I will have to practise it. She is very clearly a champion for those with disabilities, and I am very pleased to be part of the all-party group for disability, which she chairs. Yesterday, I was able to participate in some of those things that she mentioned and give a Northern Ireland perspective on them. I will probably also give a Northern Ireland perspective today on where we are with this matter.
It is also nice to see the Minister in her place. We had an expression of her interest in this subject yesterday when we had the opportunity to take part in the disability confident campaign that the hon. Lady and the Minister organised. It was good to be able to support what the Minister was doing, but it also gave me the opportunity to increase my knowledge of the subject. The one thing about being an MP—in fact, the one thing about being any person—is that we can learn every day if we want to. Of course I want to extend my knowledge, and yesterday gave me a chance to do just that. I was also able to interact with those who were there and explain to them what we were doing. For example, we are doing a number of things in my constituency in relation to this matter—I mean that private business is doing a number of things. There are also policies and strategies in place. I wish the shadow Minister, the hon. Member for Battersea (Marsha De Cordova), well and I look forward to her contribution.
It is a privilege to stand in this Chamber to represent and speak out for the many disabled people in our communities. We get our knowledge of this subject from our constituents, from our advice centres and from our everyday interaction in our communities. The briefing that the House of Commons Library so helpfully supplied said:
“Over 7 million people of working age (16-64) in the UK are disabled or have a health condition, and 3.5 million of these are in work.”
That is good news. It also stated that
“350,000 are unemployed (meaning that they are not in work but are actively looking for work)”.
I hope that this debate will provide us with the opportunity to see how we can achieve our goal. The briefing goes on to say that
“3.3 million are economically inactive (meaning they are not in work and are not looking for work).”
The fact is that some disabled people cannot work. That is a fact of life and must be accepted as such. However, for those who want to work, we should do our best to make that happen.
The employment rate of people who are disabled is 49.2%; the employment rate for people without disabilities is 80.6%. The employment rate for people with disabilities was 1.3 percentage points higher in April and June 2017 than in the same period of 2016. Over that same period, the number of people with disabilities in employment rose by 104,000. Clearly, a strategy is in place to try to address the issue, because more people with disabilities are in employment now than a year ago, so that must be good news.
Between July 2016 and June 2017, the employment rate—at 58.5%—was highest for people who were disabled in the south-west, and lowest in Northern Ireland at 36.7%. It is not often said, but the Library provides excellent information for us when we are preparing for these debates, which gives us a chance to do things well. I read the Disability Action report, “Hard at Work”, which was very interesting reading. As opposed to just citing the fact that there are only 33% of disabled people in work in Northern Ireland, it asks the question why, and I am going to ask that question in the Chamber today. I am very conscious that the Minister has no responsibility for Northern Ireland—I understand that—but in order to give some depth to this debate with facts and details, I want to add in the Northern Ireland perspective. Some things that have been done in Northern Ireland—or have not been done—can be put into practice on the mainland.
The overall employment rate in Northern Ireland is 5 percentage points lower than in Great Britain. For some groups, the gap is much wider—15 percentage points lower for disabled people in Northern Ireland compared with Great Britain. Thirty-three per cent of disabled people are in employment, which is less than half the rate of non-disabled people, and 50% of disabled applicants did not feel comfortable about disclosing their disability—I want to stress that point to the Minister because I am sure that it also applies to the UK mainland. This is something that we must address. I ask Members to forgive me for saying this, but we are all aware of the story that was in the press yesterday—I know that it is slightly different from what we are discussing today—about people having to disclose when they go for a job whether they are pregnant or intending to have a child. I think that it is wrong to ask that of anyone going for a job. The same thing applies to those with a disability. If a person does not say that they are disabled, they have a better chance of getting the job. If they say that they are disabled, will a wee box be ticked saying that they are not the right person for the job? Once in employment, disabled employees often do not feel confident about being open about their disability. Even when there is a problem in their job, they tend to keep it to themselves.
Research findings vary, estimating that between 20% and 50% of people with a disability feel that they face discrimination in employment, and less than half of the respondents to one survey had asked for “reasonable adjustments”. Again, I say to the Minister that if people feel discriminated against, or if they are afraid to ask for reasonable adjustments, perhaps there is a big role for businesses to carry out. The reasons given for not asking for reasonable adjustments were
“not wanting to draw attention to their disability”
or because “it would be embarrassing” to do so. Of those who did ask, nearly a third said that they received little or no help following their requests. Perhaps that underlines the other issue. When people ask for something, they are not even sure whether they will get it, or whether it will be done. Again, that is something that we need to look at. Perhaps sometimes we have to enforce such things through legislation and through Government intervention. It is small wonder that many people with so much to offer feel like they are a burden and unwanted in the workplace. Those concerns have been referred to by other Members today.
Concerns among employers in relation to employing disabled people included perceived risks to productivity; financial and other implications of making workplace adjustments; and confusion or negative perceptions around legislation. Perhaps people need to be more aware of what the legislation means and what it means for business as well. Despite employers’ concerns about perceived financial implications, a survey of more than 1,000 employers found that the majority provided adjustments. Let us be clear about this: the majority of businesses try to do the right thing. I am talking here about flexible working patterns and hours with no associated cost increase. I would like to ask the Minister a question and perhaps she can respond when she has the opportunity to do so. Can she tell me whether financial incentives are available for businesses to make those changes? I think that, sometimes, the cost factor does concern some businesses. If there is some help for them to make those adjustments, it would be helpful.
A recent survey highlighted the fact that 40% of respondents said that the option of modified hours—such as flexible or part-time working—would be an important factor in enabling them to enter and to stay in work. Over the years, I have had the opportunity to look at what happens with the disability living allowance, which has now moved to the personal independence payment. Even if people are on DLA, they need therapeutic work. We must understand that, sometimes, people are not fully able to carry out their duties because of their disablement, but, therapeutically, it is good for them to have some work for a certain period of time. Perhaps the Minister could give us her thoughts on that in her response this afternoon.
Perhaps most worrying for this place is that we must get our own house in order. Let me just illustrate the problem by way of an example from the civil service, but I will not name the person involved. Disabled people in the public sector still report being passed over for development and promotion opportunities, and that their performance is unfairly assessed. This suggests that talent is being wasted and a culture of discontent is being fostered. If we have not got our own house in order in government—at all levels, wherever it may be: at this level, at regional level, at council level, and so on—that is the first step that we must address in this place.
I always say, with regard to expecting people with illnesses to be in work, that it is up to Government to set the example. I often use the example, as I do now, of a young constituent of mine who worked in the civil service. She had her DDA form filled in, so her employer—the civil service—was aware that she had ulcerative colitis. She applied for a transfer to a Department closer to home to avoid the almost two-hour long rush-hour jaunt that she had to go through every day. She was not accommodated. She went to occupational health service meetings and was told numerous times that, yes, she should be off sick and should not return to work until the flare-up had settled down. She was then medically retired from work, as her employer felt she was unfit to work. She applied for benefits and was told that she was not entitled to ESA or DLA and that she should seek employment. This is the Catch-22 or chicken-and-egg situation—which comes first? The civil service expected someone to hire her, according to the ESA decision, just not itself.
Let us look at the process that she went through. At the age of 28, she was classified by the civil service as not fit to work but made to feel like a scrounger for feeling that if the civil service, with its hundreds of offices and roles and positions, could not facilitate her illness, then she would have no chance in the private sector. Thankfully, we were able to help with getting her ESA and DLA. Both claims went to appeals and reviews, but they were ultimately won. Every time she applied, we had to go through the same ritual because nobody believed that this girl could not work, despite the fact that she had been paid off because she was medically unfit. That makes absolutely no sense. We must lead by example. We must put into place initiatives that help disabled people to be confident in their abilities instead of feeling that only their disabilities are important. It is hard to expect small businesses to understand that a disability does not mean an inability to be a vital player in a team when we—I use the royal we, in terms of the civil service—are not able to do that, despite putting in place so-called protocols and schemes to prevent that from happening. This House is one place where I most certainly advocate that we get our house in order and do so quickly.
I look to my constituency and see the potential in our young people in Longstone School, which is one of the behavioural units where young people with disabilities as well as those with educational challenges are trained to work in what is sometimes, for them, a big, bad world. However, it is a world of opportunity, with so much more to offer, and we should be trying to move them towards it. Should we consider apprenticeships with financial support for those who have learning disabilities? I look to the Minister again. I have been looking to her for lots of answers; we are all doing so, because we respect her greatly. Would that help employers to think of employing disabled people as less of a gamble and to give them an opportunity? I am certain that many such apprenticeships would turn into employment.
What can we do to help those who want to work and have skills to offer, yet feel there is no place for them in the modern workplace? To me, that is what this debate is about. It is about giving them hope, vision and opportunity. If we can do that, we are moving in the right direction. I do not have the answers. My wife thinks that I have lots of answers, but I do not have answers to everything in the world. However, I try to seek out the answers, and that is the great advantage of this debate. I ask the Minister and her Department to consider this issue really seriously—I know that she will—and to come back to the House with more than a simple pledge to get disabled people into work. We need a plan to make this happen, starting with our own civil service.
I again commend the hon. Member for East Kilbride, Strathaven and Lesmahagow for her compassion and for her interest in disability. I also commend all the other Members who have come along here on a Thursday afternoon—the graveyard shift—to participate in a really important debate.

Drew Hendry: As another Member with a four-barrelled constituency name, I, too, congratulate my hon. Friend the Member for East Kilbride, Strathaven  and Lesmahagow (Dr Cameron) on bringing this debate to the Chamber. I commend the hon. Member for Strangford (Jim Shannon) for also attempting to pronounce her constituency; he did very well indeed. We heard from my hon. Friend a speech that was rich in detail, understanding and empathy. She really, truly understands the subject. I fully commend her for this very positively titled debate about the role of disabled people in economic growth. It is somewhat scandalous that we have not had the opportunity to debate this before, but that wrong has been righted today.
We in the SNP know that disabled people continue to make a fantastic contribution to our economy. All the words that we have heard here today show our empathy and the joint approach that we are taking to these issues, but comments that come from the Government themselves can do a lot of harm. Our approach to disabled people—the approach we have taken today—is in stark contrast to the UK Government’s Chancellor, who recently said that he thinks that disabled people are reducing productivity.
I would like to quote my hon. Friend, not from her speech today but from an excellent article she wrote recently:
“The answer is simple, invest in improving the pathways to work. Invest in disabled entrepreneurs, improve reasonable adjustment guidelines and encourage businesses to diversify their workforce. Create incentives rather than enforce sanctions. If the £108 million spent by the Government to deny disabled people the benefits they are entitled to was redirected to creating an apprenticeship schemes, entrepreneurship and training opportunities for example, then perhaps the narrative of people with disabilities could change.”
Those are very wise words.
I am most grateful to Scope for the briefing that it has sent along for this debate. Scope says of the Chancellor’s comments:
“We found the Chancellor’s statements before the Treasury Select Committee…on the negative impact of disabled employees on UK productivity levels to be entirely untrue and unacceptable.”
It underlines a fact that was brought out by my hon. Friend, saying:
“In fact, a 10-percentage point rise in the employment rate amongst disabled people would increase GDP by £45 billion by 2030 and result in a £12 billion gain to the Exchequer.”
I hope that the Minister, who I know to be a thoughtful person, will reflect on the Chancellor’s remarks and take the opportunity today to distance herself from them.
There is a real opportunity to make a positive impact on tackling the disability employment gap in the economy, delivering the reforms needed to support more people to enter, remain and advance in work, but progress up until now has been slow. Government and employers need to do more if we are to harness the economic benefits that an increased disabled employment rate will bring. Tackling the disability employment gap would mean, as I have said, that economic growth and productivity would increase.
Employing disabled people is an opportunity for employers, delivering significant benefits to business and the economy. It is important to underline the calls from the all-party parliamentary group on disability. They are all relevant, but I mention especially tailored and targeted support for self-employed disabled people from such bodies as the Business Bank, funding for  reasonable adjustments for disabled recipients of tech start-up support from Innovate UK, and bringing forward requirements for sectors to plan for recruitment.
It is also vital to recognise the additional challenges that are faced by disabled people. My hon. Friend talked about the high numbers of applications required simply to get a job interview, let alone a job. She said that we cannot afford to sit and wait. Throughout this debate, we have heard many people agreeing on the need for action, and that is what disabled people now want to see.

Jamie Stone: The hon. Gentleman rightly mentions the challenges and difficulties that disabled people face. One of those, depending on the form of disability, is that the fatigue element as the day progresses can be quite critical to the person. It would be best if employment opportunities could be tailored with specific reference to this fatigue, which can kick in after two or three hours of concentrated work.

Drew Hendry: I thank the hon. Gentleman for his intervention. It is important to take into account the size and scale of the challenges people face, to make sure we are able to take full advantage.
As my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow said, the UK already has a skills shortage, and the Brexit exodus of skilled labour means that the opportunity of training and apprenticeships must be embraced. As we have heard, the Government at the moment are not going far enough. Specialist advice services on self-employment are required, and we need to avoid stereotypes in these debates and the action that follows.
The additional challenges for disabled people also come down to hard cash and the extra costs that they have to cope with. New research from Scope shows that on average, disabled people have to find an additional £750 per month related to their condition, on top of any social security payments designed to meet those costs. The financial penalty locks disabled people out of being able to make a positive contribution to the economy. They need practical help, and the Government can help now. For example, the Government can help with motability, an issue that my hon. Friend is keen to bring up. Many people have seen their ability to move around or partake in employment and the economy hampered by motability issues.
It also comes down to the issue of PIP assessments. I was interested to hear from the hon. Member for Hitchin and Harpenden (Bim Afolami), and agree with him that more money should be spent on disability payments. There should be more social security to support disabled people, particularly given their disadvantage. The recent Work and Pensions Committee report on claimant experiences of PIP and ESA assessments presented clear evidence that the assessments are failing a substantial minority of claimants, with claimant stories highlighting clear errors made in assessments, crucial information being omitted and assessors lacking knowledge and expertise. It is not just about putting more money into the system; it is about making the system work for disabled people, which too often it does not at the moment.

Jim Shannon: Friday a week ago, I had the chance to meet Capita officials in Northern Ireland. I suggest to the hon. Gentleman and other Members that if it is  possible to have such a meeting, it might be helpful. We were able to get a hotline to the people who can make the changes and to ensure that the people doing the assessments are up to speed, as he said. Capita needs to change some of the things it is doing. We are going to have a change in Northern Ireland, and Capita has committed to that. I suggest that others do the same in their own regions.

Drew Hendry: That is an important comment. I am sure that the hon. Gentleman, having listened to me speak on universal credit, PIP and ESA on many occasions, can be reassured that I have indeed made that visit and gone through that process, and I know what is involved. I think his substantive point is that it is a good thing to do. It does not iron out the difficulties that people have had over years and continue to have, but it can help, and wherever it can help, we must do that.
Between April 2016 and March 2017, the Scope helpline saw a 542% rise in calls related to PIP payments, and 65% of claimants who challenge a PIP decision at tribunal are successful. There is much more that the Government can do to help.
I want to finish with some criticisms, but given that I know the Minister will be listening carefully and looking for ways to take action, I will also talk about how we are doing things back in our own constituencies, as the hon. Member for Strangford (Jim Shannon) said, and how we are doing things differently in Scotland. I hope that the Minister will listen carefully and take the opportunity to learn or think about how things might be done differently.
We have seen the impact that the UK Government’s system has had on disabled people in Scotland. In October this year, the Scottish Government found that between 7,000 and 10,000 disabled people per year are being affected by the removal of the work-related activity component of employment and support allowance. That is completely appalling and simply unacceptable. They also found that 40,000 disabled people claiming ESA have been affected by the bedroom tax. ESA is supposed to support disabled people into employment. The Government have said that the £30-a-week cut was to remove incentives to be out of work. That is an outrageous thing to do. It is pushing people into poverty and into crisis.
The Government’s PIP assessment process is failing disabled people. According to the DWP figures from December 2017, one in five claimants who had gone through mandatory reconsideration for PIP had their reward changed, meaning that 20% of those initial decisions were judged as wrong. I hope that the Minister will consider some of the actions that have been taken in Scotland, with the very limited powers that have been transferred to Scotland.
Disabled people should have equal access to employment opportunities in Scotland, and the Scottish National party Government are committed to reducing the employment gap by at least half. Disabled people’s skills, hard work and commitment are valuable to any employer, and practical and financial support must be available to businesses. It makes sense to recruit from the widest pool of talent possible.
Disabled people account for 20% of Scotland’s population, and at the moment they make up just 11% of the private sector workforce and 11.7% of the  public sector workforce. The Scottish Government will work with both sectors to look at target setting and how to redress the imbalance. In April 2017, the Scottish Government introduced employability programmes delivered by a new service, Work First Scotland, including employment support for up to 3,300 disabled people. In July last year, a campaign was launched to boost awareness among businesses of the benefits of employing people with disabilities, specifically targeting small and medium-sized enterprises.
From April 2018, a new devolved programme will take a voluntary and person-led approach to ensure that disabled people are offered support that is appropriate and built on guaranteed service expectations from providers. Disabled people engaging with the programme will receive high-quality pre-employment support that identifies and develops their strengths and assets while focusing on sustainable employment outcomes. Only today, the Scottish Government announced that people will no longer see a reduction in their benefit payments during the appeal process. In the Minister’s response, she might say whether the UK Government will consider taking that action too.
I think the message from both sides of the Chamber today has been crystal clear: let us do all that can be done to realise and release the potential of disabled people for economic growth.

Marsha de Cordova: Let me begin by congratulating the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing this important and timely debate. I commend her for the work she has led on the all-party parliamentary group for disability.
I would like to extend my thanks to a number of disability organisations, including Disability Rights UK, the Royal National Institute of Blind People, Scope, Leonard Cheshire Disability and Action on Hearing Loss, for all the work they have done on improving employment opportunities for disabled people and for the important briefings they have provided for today’s very important debate.
There are currently around 11.6 million disabled people in this country—people like me, who have factors that could act as a barrier to engaging in a wide range of valued activities, and not just economic activity, which is the focus of our debate. Disabled people make up around 16% of the working-age population, yet we face barriers in all aspects of life, including in education, transport, access to justice, access to voting, housing, health and, most importantly, employment.
Almost eight years of Tory austerity have had a disproportionate impact on disabled people. We know that half of those who live in poverty are disabled or live with someone who is disabled, in part because of the additional cost of their disability, but also because the labour market does not work well for disabled people who are able to work.
The duty to make reasonable adjustments to support disabled people in accessing education, employment, housing, and goods and services is a key feature of the Equality Act 2010. However, we know from the 2015-16 House of Lords report on the Equality Act and disabled people that the legislation needs firm Government action  to ensure that it is strongly upheld and to remove the barriers in society faced by disabled people who have a condition and/or an impairment.
It is a matter of serious concern that we have a Government who barely speak about removing barriers, while actually creating new ones through their austerity cuts and their punitive social security system. In their 2015 manifesto, the Tories pledged to halve the disability employment gap by 2020, but the TUC has found the Government to be years behind on that commitment. They have since dropped the pledge, and replaced it with a reduced commitment to getting 1 million more disabled people into work.
As we have heard, the rate of employment for disabled people stands at 49.2%, compared with 80.6% for the rest of the population in the most recent period for which figures are available, meaning that the disability employment gap lies at 31.3%. We know that the gap is even wider for specific disability groups. For registered blind and partially sighted individuals, only one in four people of working age is in work, and my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous) mentioned the employment gap for those living with autism.
The Office for National Statistics recently announced that it was suspending publication of the disability employment rate indefinitely. The motion notes the fact that there will be a disability employment gap after Brexit, and the current gap in the UK is considerably above the European Union average of 21%. That illustrates the extent of the Government’s failure to take meaningful and serious action. In the light of this, why have the Government weakened their commitment to reducing the disability employment gap? It would be helpful if the Minister set out the measures she is taking to improve the ability of disabled people to enter work and—on retention—their ability to stay in work?
Many barriers faced by disabled people are shaped by false perceptions about the role they play in the workplace. Research by the Scope charity found that almost half of disabled people have worried about making employers aware of their impairment or their condition. We know that one of the key barriers that has been highlighted is how we shape employer attitudes to employing people with a disability. What are the Government going to do to support employers—especially small businesses, given that they make up nearly half the workforce—to employ disabled people? How can small businesses access affordable and timely occupational health support, and how can best practice be shared?
I must say I was surprised that disability and disabled people were not mentioned in the Budget, giving a very negative message to the population about the role of disabled people in the economy and giving the regrettable impression that their contribution to the economy is not being championed or prioritised by this Government. Will the Minister offer an explanation for this omission? Opposition Members will build an economy that includes everybody, because that is how we can develop an economy that truly works for everybody, not just for a few.
I cannot stand at the Dispatch Box speaking on this subject without mentioning the comments made last December by the Chancellor of the Exchequer during  Treasury Committee questioning, when he linked low productivity growth with the employment of disabled people. Unfortunately, there has been no apology for those comments, and his lack of remorse following the scapegoating of disabled people for a productivity crisis created by this Government’s failed economic policy speaks volumes. Does the Minister agree that there is a need for a clear and coherent message from the Government that employing disabled people can enhance productivity and make a real contribution to organisations and businesses across the UK?
Despite that, the Government finally managed to publish their long-awaited “Improving Lives” paper late last year. Some 90% of disability and long-term health conditions are acquired, so it is absolutely right to examine how employers can make reasonable adjustments to support an employee to stay in work if they become disabled. However, the paper did not set out how the Government intend to achieve or fund this aim.
To date, the Disability Confident campaign, launched in 2014, has been a dismal failure. It has made a negligible impact on the disability employment gap, and has yet to produce any concrete evidence of results. Will the Minister confirm how many additional disabled people have found work as a direct result of the Disability Confident campaign?
The Access to Work programme, when it works well, provides invaluable support, but too often I hear about problems in relation to the administration and timeliness of payments, the cap on individual awards and the assessments. Ms French is a visually impaired person. Her experience of seeking employment is that when the subject of Access to Work came up, recruiters said that the employer was in too much of a hurry and would not be able to wait for an Access to Work assessment to be completed. As we all know, Access to Work is probably the best kept secret—it helps far too few people—and it will need significantly more resources if the Government are to get anywhere near the aim of getting 1 million more disabled people into work by 2027.
In the case of a deaf person, Mr Will, he was offered a job by a Disability Confident employer. However, once the employer realised that the Access to Work support would be capped and that they would have to meet the rest of the costs, the job offer was withdrawn. Will the Minister set out what substantive action the Government are taking to support people in work? What work have they done with disabled people to ensure that this support is flexible and responsive to need? More importantly, what additional funding will the Government make available, especially for Access to Work?
We have concerns about the language used in the Government’s “Improving Lives” paper, which centres on the idea that employment can “promote recovery”—the familiar sounding phrase, which says that disabled people and people with chronic conditions would recover if only they tried a bit harder, or were subject to an even tougher system. Will the Minister reassure people with disabilities limiting their ability to work and those actually unable to work that this is not the intended message her Government are trying to convey or that they believe in?
For nearly eight years, disabled people have borne the brunt of the cuts inflicted on them by this Government and the previous coalition Government. The cuts have had a detrimental impact on the lives of disabled people, cutting living standards and undermining their access  to education, social care and justice. In 2016, the United Nations convened a committee to investigate state violations of the UN convention of the rights of persons with disabilities. Its report concluded that the Government had committed
“grave, systematic violations of the rights of persons with disabilities.”
That is a damning indictment of the treatment of disabled people by this Government—it shames us as a country—yet the Government have failed to act. We believe in a social model of disability, and a society that removes the barriers restricting opportunities and choices for disabled people. We will incorporate the UN convention of the rights of persons with disabilities into law. I ask the Minister: why do the Government refuse to do the same?
Currently, 4.2 million disabled people live in poverty, and new evidence indicates that this number is increasing as a result of cuts in support. According to Scope, the Welfare Reform Act 2012 has cut nearly £28 billion in social security support from 3.7 million disabled people. Cuts contained in the Welfare Reform Act 2016 are adding to the suffering experienced by many disabled people, and that does not include cuts to social care, the NHS, education or transport—all of which have had a direct effect on disabled people.
Research by Scope that was published this week revealed that on average, disabled people face extra costs of £570 a month due to their impairment or condition, and that is on top of social security payments that are designed to help meet these costs. Extra costs mean that disabled people’s money simply does not go as far—£100 for a non-disabled person is equivalent to just £67 for a disabled person.
In addition to the four-year freeze in social security support, the 2016 Act cut financial support by £1,500 a year to half a million disabled people who had been found not fit for work, but who may in the future be in the ESA work-related activity group. Will the Minister provide the House with an assessment of the impact of social security cuts on disabled people and their ability to stay in work? The current social security system is not working for disabled people. Analysis this week by Demos into the treatment of unemployed disabled claimants revealed that they are up to 53% more likely to be docked money than claimants who are not disabled, and disabled people have been hit by 1 million sanctions since 2010.
Under this Government, the social security system has penalised people with disabilities by cutting much needed support and making it harder for them to access what support is available. The assessment processes for ESA and PIP are not fit for purpose, and trust in the system has been completely undermined. The widespread distrust of the assessment process by sick and disabled people is no surprise, with a record 68% of PIP decisions that are taken to tribunal being overturned by judges. Under private contractors the assessment process is getting worse, not better. Why will the Government not act to end privatisation, and replace the current system with a more holistic process?
I welcome the opportunity to contribute to this important debate, and I congratulate all Members on their contributions. However, the Government must understand that for too many disabled people, the reality is a social security system that punishes rather than supports them,  and a labour market that shuts them out rather than being open to their potential and skills. It is incumbent on the Government to harness the potential of everyone, and to create a truly inclusive society that works for the many, not just the few.

Sarah Newton: I add my congratulations to those already offered to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron). I will not go through the names of everybody’s constituencies because I have so little time left, but she did a magnificent job in introducing this debate. I echo words from Members across the House about her commitment to this important issue, her sincerity, and the way that she opened the debate in such a positive way—sadly, that was in marked contrast to some of the later contributions. I praise the work of the all-party group for disability, and all voluntary sector organisations that, in myriad ways, do so much to support its work.
It is important to hear voices from across the House, and we heard powerful, personal testimony from the hon. Members for Eastbourne (Stephen Lloyd), for Caithness, Sutherland and Easter Ross (Jamie Stone), and for Battersea (Marsha De Cordova) about their lived experience of disability. They have all made significant contributions to improving opportunities for disabled people to play their full part in society. The hon. Member for Battersea raised some individual cases, and I would appreciate her providing me with the specific details so that I can resolve those matters.
I congratulate my hon. Friend the Member for Hornchurch and Upminster (Julia Lopez) on becoming a Disability Confident employer. Yesterday she joined 78 Members of Parliament who have already done that, and there will be further such opportunities in the weeks and months ahead for those who have yet to take up the scheme. I praise her for and encourage her in the work that she will do in her constituency with Jobcentre Plus. Such work that we can do in our constituencies, by helping local employers to take seriously our desire to see more disabled people in employment, is important and powerful. She raised an important point about enabling disabled children to develop their employment skills and have the same opportunities as all other young people to gain work experience. She will be pleased to know that the Department for Education completely agrees with her, and it is increasing its commitment and funding to enable young people to have supported internships.
My hon. Friends the Members for Hitchin and Harpenden (Bim Afolami) and for Chippenham (Michelle Donelan) made powerful speeches about the level of ambition that we all share to close the disability employment gap. They stressed the importance of working closely with employers on culture change, and I completely agree. We are considering the issues they raised about improving the Disability Confident scheme, although I refute what was said by the hon. Member for Battersea—this is not a failing scheme; it is a growing scheme. We are looking at what more we can do to incentivise businesses, and at publishing levels of disability employment, especially for large employers. We are also considering what more we can do to communicate the wide range of help that is available to support businesses and public sector organisations to employ disabled people.
I congratulate the hon. Member for Strangford (Jim Shannon) on becoming a Disability Confident employer yesterday. He said how important it is that people feel confident enough to disclose their disability, and for employers to feel confident in hearing that news, and he asked how we can work together to ensure that happens. Financial support is available to a disabled person through the Access to Work programme, as well as to employers who employ them.
I assure the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry) that each and every year we increase our investment in benefits for disabled people and those with health conditions. This year alone we are spending more than £50 billion—more than the defence budget—and I am proud to be part of a Government who prioritise supporting disabled people. That is an increase of £7 billion since 2010. We are determined continuously to improve the processes and operation of the system that administers our disability benefits.

Drew Hendry: I hope that the Minister will also address the comments made by the Chancellor and distance herself from those. On her specific point, what does she say to those who have lost the severe disability allowance from their payments?

Sarah Newton: I was not going to dignify the hon. Gentleman’s remarks with a response, but since he has intervened on me I will not leave that point without comment. It is irresponsible of him deliberately to misrepresent what the Chancellor said at the Select Committee. We in this House all have a huge responsibility to be careful about what we say. We must honour the truth, and we must not make comments that scaremonger and will frighten some of the most vulnerable people.

Drew Hendry: rose—

Sarah Newton: I will not give way. I have been generous in giving way, and I will not indulge the hon. Gentleman any more in pursuing things that he has misrepresented and quoted out of context.
Let me return to the spirit of the debate, which the hon. Gentleman’s colleague, the hon. Member for East Kilbride, Strathaven and Lesmahagow set so well. The House came together to speak to disabled people outside the Chamber, to show how much we value them, and to say how much more we want to do to enable them to play their part in society and to enable employers to take people on. I will return to the tone so ably set by the hon. Lady. I hope that the hon. Gentleman will respect his colleague and the tone that she set.
Last week I visited North Devon District Hospital with the excellent local Member of Parliament. We met some young people who are doing really valued jobs in the hospital wards with patients and in vital support services, such as the engineering department. All those excellent young people had been supported by their local college and by Pluss through a Government-funded scheme. They were supported through work experience and placements in the hospital. The programme has been working for some five years. All the young people have learning disabilities, but their employers told me how valued they are. They were being employed not as an act of charity, but because of who they were.
I have the privilege, as Minister for disabled people, to meet disabled people every week who do extraordinarily good work in every sort of workplace across the country. Just this morning, I was at Channel 4, which kindly hosted the first anniversary of our sector champions. Each sector champion is a leader in their industry and is working to improve access for disabled people to their industry, from financial services to retail, tourism, media and transport. Each sector leader is an inspirational leader in their field, driving real change in access for disabled people. They are doing that not just because it is the right thing to do, but because it makes good business sense.
There are an estimated 13 million disabled people in our country. Each year they spend an estimated £250 billion —the purple pound—so if businesses are not accessible they are missing out on a great deal of business. Accessibility, as Members have said, does not have to be expensive. Our sector champions are sharing best practice and information, so that more people are confident about employing disabled people. Disabled people are making huge contributions not only as consumers, but, as we have heard today, in all aspects of our society, including employment.
The Government are building a Britain fit for a future where no one is left behind. We have been very clear that we want our economy to harness the skills, talents and contributions of every person in society. We have made significant progress—there are now 600,000 more disabled people in work than there were four years ago—but we want to go further and faster. At the moment, even though our labour market is the strongest it has been for many years, with employment rates at record highs, we know that only half of all disabled people who would like to work are in work. New analysis shows that, over the course of a year, disabled people are twice as likely to fall out of work and almost three times less likely to move into work compared with non-disabled people. That is simply not acceptable.

Jamie Stone: Apropos of what the Minister has just said, does she agree that being disabled in a very remote area, such as my constituency, means that travelling to work poses very special and difficult challenges? The Government will have to think very carefully about that, so that my constituents are not disadvantaged.

Sarah Newton: The hon. Gentleman makes a really good point. I represent a constituency in Cornwall, so I completely empathise with the issue he raises. Access to work funding is available, including for transport to enable people to get to their place of employment. It is also very important that local enterprise partnerships work with local authorities to look at what more can be done to join up community transport with public transport. In areas such as the ones we represent, public transport is not as good a service as it is in urban areas, so there is more work to be done.
With more than one in six people of working age reporting a disability, it is really important that we do everything we can to make sure that their talents do not go to waste. That is why we have an urgent and comprehensive set of plans and actions. For example, we have a personal support package, some £330 million of funding, to arrange new interventions and initiatives for those in the WRAG, so that they can have tailor-made personal support to enable them to take the steps to work.  We have already recruited over 300 additional disability employment advisers, bringing special advice and support into the jobcentre. We have begun introducing 200 new community partners who are able to share their lived experience of disability across our jobcentre network.

Jim Cunningham: Will the Minister give way?

Sarah Newton: I am not going to take any more interventions, because I can see from the Chair a slight impatience. There is a second debate this afternoon and there are some points hon. Members have raised that I really need to address.
Our work and health programme has now launched. It has a contracted value of over £500 million to provide specialist support, including to disabled people. A very important point was raised this afternoon about the entrepreneurial spirit of disabled people. Our new enterprise allowance has helped nearly 20,000 disabled people to start up businesses. More than one in five of all businesses set up under the scheme are led by disabled people. We also have a small employer offer to help more disabled people into employment.
I encourage Members to read the “Improving Lives” Green Paper on the future of health and work, which sets out a very ambitious plan of detailed actions and investments the Government are taking, including in assistive technology. It is absolutely not what the hon. Member for Battersea said it was. We are not saying those things, which I am not going to repeat in this House because they are so fundamentally wrong. What we are about is recognising the talents of disabled people and making sure there are no barriers and no limits, so that their talents can take them as far as they possibly can.
I am absolutely delighted to say that the devolved Administrations are taking all sorts of different actions in different parts of the country. We are working very closely with the Scottish Government. We are jointly funding the Single Gateway project in Dundee and Fife, which is a really good and innovative programme. I am looking forward to working closely with it to see what lessons we can learn so that we can roll it out. It provides a single point of contact between the jobcentre, employers and disabled people. We will continue to work closely with the devolved Administrations to see what more we can do.
I again congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow on bringing this issue to the House. Achieving our ambition of seeing at least 1 million more disabled people in work requires all of us to work together. The Government of course have a role to play, but so too do employers, the health service, local authorities, charities and the voluntary sector.  MPs have convening powers and the power of championing in their local community. All have vital roles to play. I hope they will support me and the Government in delivering our very ambitious vision for a society in which disabled people can play their full part and go as far as their talents will take them.

Lisa Cameron: I thank all Members, from across the House, who have taken part in this extremely important debate. We have done it justice, but this is just a starting point for the work ahead that we take together. I am extremely keen that people become Disability Confident employers. I encourage MPs to do that and to hold Disability Confident events in their constituencies to encourage local employers. I pay particular tribute to Mr Speaker, who has created an internship scheme, to run over the next five years, for people with disabilities to come and work in Parliament with MPs. It is extremely important that Parliament is a role model that leads the way, and that we do not just talk the talk but walk the walk. He is a shining example in that regard. We are, as we have heard today, in politics to make a difference to enable. Together we can create the inclusive society that everyone deserves.
Question put and agreed to.
Resolved,
That this House recognises the potential talent pool within the disabled community; notes that there will be an employment gap after the UK leaves the EU and that there is ample opportunity to include disabled workers in economic growth; calls on the Government to act immediately on its commitment to get one million more disabled people into employment by 2027; and further calls on the Government to increase awareness within the business community of the benefits of employing an inclusive workforce.

Eleanor Laing: We now come to the Back-Bench debate on cancer strategy. Before we begin, I remind hon. Members—some of the offenders have just left the Chamber—that we do not have unlimited time in this place. I did not impose a time limit in the last debate because I thought it would run naturally to finish about 15 minutes ago. It did not; it overran. The mover of the motion, all three Front-Bench speakers and two other Members significantly exceeded the time they ought to have taken. I was hoping that in a good-natured debate we might have some self-regulation, but that did not happen. In the next debate, therefore, I may have to impose time limits. Members in the next debate will have less time to speak because their colleagues in the last debate took longer than they ought to have. I will leave it to hon. Members—some of the offenders have left the Chamber, but I will find them later—to act honourably. As I call Dr Lisa Cameron, who is working very hard this afternoon, to move the next motion, I hope that she will do so in 15 minutes or less.

Cancer Strategy

Lisa Cameron: I beg to move,
That this House has considered the Cancer Strategy.
Thank you, Madam Deputy Speaker, for your guidance. I will try to behave much better timewise in this debate, which it is an honour and a privilege to introduce. I pay tribute to the Backbench Business Committee for enabling the debate, to the all-party parliamentary group on cancer for its timely and extremely important report and, in particular, to the hon. Member for Basildon and Billericay (Mr Baron), who could not be with us today but deserves our thanks for the extraordinary amount of work he has done on this issue.
We in the House are all on the same side against cancer and in our ambition to achieve world-class cancer outcomes. My speech will address—briefly, according to your instructions, Madam Deputy Speaker—the recommendations of the all-party group’s recent report, “Progress of the England Cancer Strategy”. The report received more than 80 contributions from charities and bodies and truly reflects the passion in the sector, but it is also a cry for help, progress and a positive way forward. My speech will address the report’s four main areas of concern: workforce strategy, data, transparency and funding. It is open to colleagues to raise all aspects of cancer care and treatment, but, on behalf of the all-party group and the hon. Gentleman, I will stick to the recommendations in the report.
The report considers progress as we reach the halfway point of the NHS cancer strategy 2015-20 and is the result of an inquiry that the all-party group held last summer and autumn. The inquiry was formally launched at a summer reception last July and the number of written submissions was far larger than anticipated, showing the dedication of those working in the field. Many submissions came from cancer alliances and others on the frontline of the services being provided and identified many pressures and challenges. The evidence from frontline services in particular seemed to amount to a call for help. In its report, the all-party group concluded that although progress had been made since the launch of the strategy, the NHS
“will struggle to achieve the objectives set out in the Cancer Strategy unless corrective action is immediately taken.”
To this end, the all-party group has listed recommendations, a copy of which will shortly be sent to all MPs. The lack of workforce planning emerged as a key concern. The cancer workforce is constantly recognised as the biggest barrier to implementing our strategy. We are all pleased that Health Education England published its report into the cancer workforce in December 2017, but it was originally promised for December 2016. According to written evidence from Breast Cancer Now, the workforce is the greatest challenge in delivering the cancer strategy. The all-party group also heard that transformation funding is being withheld from cancer alliances because of their performance against the 62-day waiting-time target—a new conditionality of funding that emerged only after the bidding process had closed.

Jim Cunningham: I appreciate the hon. Lady acknowledging the cancer organisations, such as Macmillan, which often rely on subscriptions.  Does she agree—I am sure she does—that the public should be encouraged to give more subscriptions where possible?

Lisa Cameron: Absolutely. The hon. Gentleman makes an excellent point. These agencies are working on the frontline with people and families at their most vulnerable and deserve all our encouragement, praise and, of course, funding.
In addition to setting out how cancer alliances are to be funded and supported for the duration of the strategy and into the future, the all-party group strongly recommends that the 62-day waiting-time target be immediately decoupled from any release of funding to the alliances. The previously mentioned issues prevent progress in improving cancer care and treatment, which is not our collective vision. The all-party group also heard that improving transparency in priorities and accountability would help to support the delivery of the strategy. At the moment, a lack of clarity and lines of communication are delaying its implementation. Publishing a detailed progress update on each of the strategy’s 96 recommendations would be a positive step forward.
It is generally accepted that the 62-day waiting-time target has been treated as a higher priority among clinical commissioning groups and cancer alliance leaders than survival or stage at diagnosis, as shown by the linkage between funding and performance against the measure. Decoupling funding from process and target performance in favour of a greater focus on outcomes would strongly be in the interests of patients, not least because, if outcomes are good and survival rates increasing, processes will also be functioning efficiently and correctly.

Bambos Charalambous: The 62-day target has not been met since 2014, so the issue has been around for a while. Does the hon. Lady agree that more funding is needed if the target is to be met as soon as possible?

Lisa Cameron: I absolutely agree with the hon. Gentleman. It is essential that the target be met and that resources be put in to ensure that it is.
The all-party group also found that access to detailed and timely data is critical for the strategy’s success, particularly in relation to data for rare and less common cancers. Strong concerns were also raised about how future data protection regulations might affect surveys, such as the cancer patient experience survey. The value of the cancer patient experience survey should be emphasised, along with outcomes from patients. We must hear from those who are experiencing services; they know how to improve things. In addition, the ageing UK population cannot be left out of the conversation. The cancer patient experience survey suggests that older people are less likely to have access to a clinical nurse specialist. Additionally, older patients are less likely to know the full extent of their illness. Age discrimination must come to an end, especially in cancer care.
The all-party group recommends that the NHS and Public Health England’s data team work to produce more timely cancer data and make them publicly available. It advocates that the Government ensure that the cancer patient experience survey and other such surveys can continue in a way that allows patient experience to be considered on a par with clinical effectiveness, rather than leaving patients without sufficient information regarding their cancer and care.
Furthermore, for specific cancers such as breast cancer, there are key priorities for delivery in the cancer strategy. It must ensure that data are collected for people living with incurable secondary cancer; that everyone with secondary breast cancer has a specialist nurse with the right skills and expertise; and that everyone has access to the right support after finishing treatment for primary cancer so that they are able to live well after breast cancer. We should not ignore the fact that the strategy has had positive effects. In the last year, 16 cancer alliances and three vanguards have been established, and £200 million has been made available to them for earlier diagnosis and post-diagnosis support. In addition, 23 NHS trusts have now received new and upgraded radiotherapy machines. However, as the report makes clear, much more work still needs to be done.
In the few minutes that I have left, I want to speak a bit more about less survivable cancers. The Less Survivable Cancers Taskforce was in touch with me prior to today’s debate. It is made up of Pancreatic Cancer UK, the British Liver Trust, the Brain Tumour Charity and Action Against Heartburn, covering oesophageal cancer, and Core, covering all digestive diseases. The staggering 55% gap in morbidity is absolutely unacceptable. Much, much more must be done. Recently, I lost a very dear uncle to pancreatic cancer. As a family going through that experience, we know that we need much more research and much more specialist understanding. We need investment in those areas—it is absolutely crucial. I want to ensure that other families have a better chance of an improved survival rate, and I pay tribute to my own uncle for his courage in coping with that condition right to the end.
Hospice care is also absolutely essential. We must ensure that families and patients have dignity at the end of life. That is imperative. I have watched far too many family members die in hospital beds, surrounded by other patients with the curtain screens drawn, to know that that is not dignified and that where possible, we must improve services and access to hospice care.
I pay tribute to the Teenage Cancer Trust—we often think of cancer as an illness that affects older people, but young people are also diagnosed with cancer—which does fantastic work. Vanessa Todd in my constituency is an absolute advocate for the Teenage Cancer Trust. Although GPs may not expect a young person to come with such symptoms, which are perhaps not easily identifiable, it is something that we can increase awareness of to make sure that diagnosis is very quick and timely for young people to improve their prognosis.
I thank everybody and, again, I thank the all-party group. It has been a privilege to open the debate for the hon. Member for Basildon and Billericay, who leads the group on these issues so well.

Eleanor Laing: Before I call the next speaker, I say to hon. Members that I am going to try to continue my experiment of seeing whether people will self-regulate and behave in a decent, honourable fashion. That means taking eight to nine minutes, and not 13, 14 or 15 minutes. I trust the well experienced Mr David Tredinnick to do so first.

David Tredinnick: It is an honour to be called to speak first from the Government Benches, Madam Deputy Speaker. I heard what you said about time and intend to respect it.
On 25 January, in the other place—the House of Lords as we tend to call it now—a very distinguished former Secretary of State for Culture, Media and Sport and former Minister for the Olympics, someone who did much to bring the Olympics to London, Tessa Jowell, now Baroness Jowell, made an impassioned speech about the brain tumour from which she is suffering. That is something with which I can identify. I do not usually talk about family matters, but I will share with the House that my sister died of a brain tumour.
What Baroness Jowell said in her speech should be marked well by the Under-Secretary of State for Health, my hon. Friend the Member for Winchester (Steve Brine), who has, I know, a strong interest in cancer. She said:
“For what would every cancer patient want? First, to know that the best, the latest science was being used and available for them…What else would they want? They need to know that they have a community around them, supporting and caring, being practical and kind. While doctors look at the big picture, we can all be a part of the human-sized picture.”—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]
Yesterday at the all-party group on cancer, of which I have the honour of being a vice-chair, one of the things we looked at was recovery packages, which are very dear to my heart as the Member who has chaired the all-party group for integrated healthcare for much of the 30 years for which I have been in this House. My researcher, who has worked with me for 20 years, told me today that I have chaired more than 120 meetings of that group. Over the years, among other things, we have tried to look at how to support cancer patients in a broader way.
Let me share a figure with the House straight away. In the United Kingdom, according to Cancer Research UK, 33% of those who have cancer use some sort of additional support therapy, often complimentary therapy. For some types of cancer, such as breast cancer, this number is even higher, at almost 50%. People use these treatments because when used alongside conventional cancer treatments such as radiotherapy or chemotherapy, they make it easier for them to cope with the cancer and to feel that they play a part in how they cope. Such treatments help them relax, reduce stress, enable them to take a more active role in their treatment and recovery in partnership with their therapist, and enable them to feel more in control of their feelings and emotion. There is very strong evidence that these therapies work effectively, although more research is always welcome. The use of acupuncture to relieve sickness caused by some chemotherapy drugs is now well established, as well as to relieve a sore mouth after having treatment for head and neck cancer.
Not far from here there are three good examples of how these additional therapies have helped. At Guy’s and St Thomas’ NHS Foundation Trust the outpatient clinic offers aromatherapy, massage, reflexology and reiki. Quantitative data analysis show a statistically significant improvement. At the Royal Marsden, a world-renowned hospital not far from here, aromatherapy massage has been used on 1,000 patients to date. At the Full Circle Fund Therapies clinic at St George’s University Hospitals NHS Foundation Trust, they are using reflexology, massage therapy and relaxation training. Professor Ted Gordon-Smith, professor of haematology there, said that the
“Full Circle Fund therapy team has made a fantastic difference to the wellbeing of our patients.”
There are other citations.

George Freeman: I know, having been a Health Minister, of my hon. Friend’s assiduous commitment to this cause. He mentioned the noble Baroness Jowell. Does he agree that, with the sight of her and the Prime Minister together embracing, the Prime Minister’s announcement of £40 million for brain cancer is good news and that that is being done in the spirit of cross-party commitment to tackling disease? It will give a lot of hope to that community.
On the point about alternative therapies, does my hon. Friend agree that it is very important that the medical community and, through Government, the National Institute for Health Research do the research to examine those therapies? Although they might not be rooted in a tradition of empirical science, if there is data that shows that they help patients’ recovery time, that is worthy of consideration.

David Tredinnick: My hon. Friend has helped me on my path. Various trials have taken place: randomised control trials, observational studies and quality-of-life studies. The person who came up with the notion of evidence-based medicine, Professor Sackett, said:
“The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence”.
In plain language, that means, “You have to look at the patient and see what the patient thinks and what the patient’s experience is.” We are often told by Ministers and others that we need more evidence—that there must be evidence. The trouble is that when evidence is produced on the basis of proper trials, it is often ignored.
The subject on which I have chosen to focus this afternoon is healing—therapeutic touch; call it what you like. There is very good evidence that people are able to use their hands to transfer some kind of energy. I have studied Reiki myself—I have done it twice—as well as another Japanese tradition. I once ended up speaking to 5,000 therapists at a conference in Japan, believe it or not, many years ago.
According to Cancer Research UK, a study conducted in 2007 found that up to 40% of people in America used some kind of what they termed spiritual healing. In this country, there is good evidence to suggest that seeing a healer helps people. In the UK, long-term hormone therapy for women with breast cancer can be enhanced and patients can be helped if they are given healing therapy for the side-effects of their treatment. A study showed that a number of women who were given the therapy for 10 weeks experienced fewer side-effects.
In the national health service, there was a two-year trial involving 200 hospital patients with long-standing illnesses. It was the largest clinical trial of its kind, and was funded by the national lottery and supervised by the University of Birmingham, a Russell Group university known for its first-rate research. The methodology was used to assess the effectiveness of healing in dealing with irritable bowel system and inflammatory bowel disease in 200 patients. After the assessment, the Measure Yourself Medical Outcome Profile showed a significant improvement after six, 12 and 24 weeks.
That trial was scientific and properly carried out, and I think that if healing worked for those problems, it would almost certainly work for cancer. I suggest to my hon. Friend the Minister that if a drug showed the   same results, especially at such minimal costs, it would be recommended by the National Institute for Health and Care Excellence. More research and trials are needed.
Some of the Government’s efforts to bring about more rigorous assessments of therapies have involved the Professional Standards Authority, which was set up to oversee the UK’s nine health and care professional regulatory bodies. It was previously known as the Council for Healthcare Regulatory Excellence. In February 2013, it launched a Government-backed accredited register scheme. There are now 24 accredited registers covering 31 occupations and 80,000 practitioners. They include the Association of Child Psychotherapists, the British Acupuncture Council, the British Association of Sport Rehabilitators and Trainers, the Federation of Holistic Therapists, the National Hypnotherapy Society, and many others. In its summary, Harry Clayton, chief executive of the Professional Standards Authority, said that
“a key recommendation is for practitioners”
whom the PSA is regulating
“to have the authority to make direct NHS referrals—in appropriate cases—thereby reducing the administrative burden on GP surgeries.”
I ask the Minister to take note of that: it is saying that practitioners on that PSA register should have the authority to make direct NHS referrals. If that were possible, we would bring into the service 30,000 practitioners.
Madam Deputy Speaker, I am trying to figure out how long I have been speaking for; perhaps you can guide me.

Eleanor Laing: I can guide the hon. Gentleman: about 11 minutes to date, but he has taken a few interventions. Therefore, I am not compelling him to sit down, but I am sure he will conclude quite soon.

David Tredinnick: I conclude by saying that I am encouraged that Leicester’s hospitals have entered into a memorandum of understanding with the Affiliated Hospital of Nantong University in China. The agreement intends to promote co-operation on medical research, training and education between the institutions.
I have used Chinese medicine for 20 years, and I believe—from that and from the testimonials I have received—that the use of acupuncture to increase the flow of energy in the body and the use of herbal medicine dramatically increase the sense of wellbeing of those who suffer from cancer and frequently extend their lifespan. I commend the hospitals of Leicestershire for discussing this with the authorities in China, to look at the possibility of training therapists in Chinese therapy. I rest my case.

Colleen Fletcher: It is a pleasure to follow the hon. Member for Bosworth (David Tredinnick), who made an interesting speech. I also thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this important debate.
We all know someone who has had, or has been affected by, cancer. My family is no exception: both my parents had cancer and my husband lives with cancer every day of his life, and I could talk about cancer forever—but, Madam Deputy Speaker, I will try to limit myself to the recommended time.
The cancer strategy sets out strategic priorities and recommendations which aim to improve radically the outcomes that the NHS delivers for people affected by cancer, yet we also know that the specific needs of blood cancer patients are not being fully met by the cancer strategy. That is primarily because the experience of blood cancer patients is different from that of solid tumour cancer patients, so general cancer services are not always effective in meeting their needs.
These unmet needs occur in a number of priority areas identified in the cancer strategy, including awareness and early diagnosis, patient experience, living with and beyond cancer, access to new treatments and research, and NHS commissioning. Today, I want to focus on one particular issue: the need to improve post stem cell transplant care for blood cancer patients. This issue overlaps with a number of the aforementioned priority areas: patient experience, living with and beyond cancer, and NHS commissioning.
It is estimated that by 2020 there will be more than 16,000 people in the UK living post transplant, many of whom will be experiencing both physical and psychological side-effects from their treatment which can last for months or even years. The side-effects can include graft versus host disease, second cancers, infertility, depression, isolation and post-traumatic stress disorder.
Unfortunately, we know that there are worrying gaps in the care and support available to stem cell transplant patients after treatment. It is particularly concerning that only half of those who need psychological support actually receive it. The same is true for practical support: one in five are not offered any specialist care to help with elements of their physical recovery. These statistics are reflected in the experiences of many blood cancer patients, who feel that the level of support available to them falls away when they are sent home after their transplant. They feel that they have no one to talk to about the effects of the transplant, the challenges of late complications, the psychological burden of living with and beyond cancer and its treatment, their dietary needs, their infertility problems or practical issues such as when they can start to resume the everyday activities that they enjoyed before their treatment started.
This is happening because the commissioning of post transplant services is simply not working for every patient. After 100 days, responsibility transfers from NHS England to the clinical commissioning groups, but evidence suggests that this arbitrary cut-off can lead to fragmentation and gaps in the care and support offered to patients. To remedy this situation, there must be a review of the 100-day cut-off, as well as of the care currently provided to patients after a stem cell transplant, to ensure that all patients can access the support they need. This includes ensuring that all patients have access to appropriate emotional and psychological support services, and to a clinical nurse specialist or the equivalent model of support, both of which are pledges in the cancer strategy.
This issue very much ties into what the cancer strategy says about the commissioning of cancer services being “highly fragmented”. The strategy recommended
“setting clearer expectations, by the end of 2015, for how cancer services should be commissioned”,
and as we head rapidly towards 2020, it is important that we continue to work hard to resolve the confusion that still exists. I hope that the Minister will be able to  update us on how work in that area is progressing. I have outlined just a few of the priority areas where much more needs to be done to ensure that blood cancers and the needs of blood cancer patients are appropriately addressed by the cancer strategy. I believe that thorough and robust action in these and a number of other key areas will have a significant impact on outcomes for blood cancer patients, improving care on their journey from diagnosis to treatment and through to recovery.

Craig Tracey: I am delighted to be taking part in today’s debate. I know that this is an important area for the Government. I congratulate the members of the all-party parliamentary group on cancer on securing time for the debate today. Since 2010, the Government have recognised the need to improve cancer services offered by the NHS and to make the UK a world leader in cancer research, diagnosis, treatment and care. Many innovations have been introduced, including the cancer drugs fund and the implementation of the independent cancer taskforce’s strategy. Cancer survival rates are at a record high, and access to the world’s leading cancer drugs continues to improve. It is clear that a lot of great work is already being done.
I would like to focus specifically on breast cancer. It has been a real honour for me to be co-chair of the all-party parliamentary group on breast cancer for the past three years. This has given me the chance to meet and work with a range of really inspirational people, from patients through to clinicians. It is great to see two former chairs of the group representing both Front Benches here today. During his time as chair, the Minister in particular did some really good work on age-related risk, and it is good to see that he is carrying that on. I hope that we will be able to tempt him to talk about some of the work he is doing when he speaks later.
As we know, breast cancer is the UK’s most common cancer, with 11,500 women and 80 men dying from the disease every year. That said, great strides are being made in diagnosis and treatment, leading to survival rates doubling in the past 40 years. One of the key recommendations in the cancer strategy is on early diagnosis, with a target that, by 2020, 95% of patients will be diagnosed and receive results within four weeks. I want to concentrate my remarks on an area that is critical to achieving that ambition, and that is often referred to as the biggest breast cancer risk that women are not aware of—namely, breast density.
During my work with the APPG, issues surrounding breast density have become clear, particularly the increased risk and the masking of cancers in mammography. Mammograms are obviously the main method of national screening and, while considered the gold standard, evidence shows that they are not as effective for women with dense breasts. Before I move on, it is important to understand the implications of breast density. It is not uncommon, with 40% of women aged over 40 having dense breast tissue. Although it is completely normal to have, it is also a well-established predictor of developing breast cancer. Women with the highest density are between four and six times more likely to develop the disease than those with less dense breasts.
The challenge is that tumours show up as white on a mammogram, but so does the dense tissue, meaning that the cancer is missed in more than 50% of cases.  To illustrate the significance of that, it is useful to recount a couple of examples given to me by patients that highlight the importance of the issue and the differences in approach by country. One lady living in the UK underwent mammogram screening from 2004 to 2012, receiving a clean bill of health each time. Shortly after her fourth mammogram, she found a lump, which was later found to be 7 cm in size and had been missed for over 10 years due to her breast tissue being 75% dense. She underwent a mastectomy and, as a result of her illness, was forced to give up her business. Six years later, she continues to undergo breast construction surgery. Compare that experience with that of another patient I met who lives in France. In 2016, her first ever mammogram was clear. However, as she was also diagnosed as having dense tissue, she was immediately referred for an ultrasound scan, which revealed an 8 mm invasive tumour. As a result of the early detection, she received minimal treatment and an extremely positive outcome. Sadly, the first experience is not unusual, with 3,500 breast cancers going undetected each year in the UK alone.
I am aware that there is a global movement to educate not only women, but also health professionals about the implications of density, with a view to ultimately saving lives by promoting earlier diagnosis so that tumours can be found when they are small. In the USA, 30 states have passed legislation to provide women with some level of information on breast density, detailing the increased risk they face and how effective mammograms are likely to be for them. Having raised it with the Minister previously, I know that he has a great deal of interest in this area, and it is pleasing that some action is already being taken in the UK, with the Government commissioning research from the University of Warwick. However, clear evidence shows that high breast density eclipses family history as a risk factor for actually developing breast cancer.
What are the solutions? In an ideal world, the answer would be to change screening guidelines and offer further screening to those women at risk. For changes on this scale, I appreciate that we need to await the outcome of the research so that long-term decisions can be reached, but a relatively straightforward solution can be achieved right now. We should not ignore the breast cancer experts in the UK, who are already educating about breast density, as there is a definite need to promote awareness not only to women, but health professionals, including GPs, who are the usual first port of call for women concerned about their health. The simple task of educating about breast density can potentially promote more positive health outcomes, lead to less harsh treatments, reduce mastectomies, avoid secondary cancers and, ultimately, save lives.
In conclusion, I have learned an awful lot about breast density over the past two years, and I would like to think that more people will be informed about its potential impact as a result of today’s debate. However, the following questions remain: Do the women in your family or among your friends know the risk from breast density? Does your mother, wife, sister or daughter know that a clear mammogram may not actually be clear? Those potentially life-saving pieces of information should be available to every single woman to ensure that the Government’s excellent ambition to deliver world class cancer outcomes and even better cancer survival rates can be achieved.

Nicholas Dakin: It is a pleasure to follow the hon. Member for North Warwickshire (Craig Tracey), who reminds us of the importance of using the expertise and knowledge we have in the system to accelerate improvements in outcomes.
I thank the hon. Member for Basildon and Billericay (Mr Baron), who I know is disappointed not to be here, for securing the debate and for his time and dedication in chairing the all-party parliamentary group on cancer so well and so impressively over the past nine years.
This debate focuses on the cancer strategy and the current challenges it faces. It is important to reflect on the positives, too. In the space of my lifetime, the progress on understanding, diagnosing and treating cancer has been remarkable. In the 1950s there was limited knowledge of cancer and of the associated risk factors, the NHS had only recently emerged and there was no co-ordinated plan to treat cancer. We have come a very long way since those early days.
Cancer survival rates have doubled in the UK since the 1970s, which is a real credit to the countless health professionals, researchers, volunteers, charities and, of course, patients who have pioneered progress and who continue to do so every day. It is because of them that we are where we are today, where a person in the UK is more likely to survive cancer than to die from it.
However, massive challenges remain. My constituent Maggie Watts came to see me after losing her husband, Kevin, to pancreatic cancer in 2009. It is her fault that I have ended up as chair of the all-party parliamentary group on pancreatic cancer—thank you, Maggie. Kevin’s mother died of pancreatic cancer 40 years earlier, and the shocking thing is that Kevin’s chances of survival were no better than his mother’s. In most parts of life the world has moved on rapidly in 40 years, but it has not done so in that part. In fact, at less than 7% in the UK, pancreatic cancer has the worst five-year survival rate of the 20 most common cancers, with the UK ranked 26th out of the 27 EU countries, according to the Association of the British Pharmaceutical Industry. Sadly, pancreatic cancer is on course to become the fourth biggest cancer killer by 2026, so action is needed now.

George Freeman: Does the hon. Gentleman agree that, if we are to tackle such cancer outliers, it is vital that, as well as the great research we do in the UK, we make sure that the NHS is better at adopting and taking up innovative medicines? A large part of the accelerated access review, the genomics programme and the informatics programme is about making sure that the NHS is capable not just of doing the research but of enlightened procurement to take up more quickly the drugs that work.

Nicholas Dakin: Absolutely, and I will come on to that later.
As the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who introduced the debate so well, pointed out, we are now almost halfway into the five-year implementation plan of the Government’s cancer strategy for England. At this mid-point there are concerns about the rate of progress being made, and the workforce plan is not yet as effective as we would wish.
For example, as the Royal College of Pathologists has said, it can take up to 15 years to train a pathologist. Pathology services are unable to recruit to vacant  posts today, and it is anticipated that a third of consultant histopathologists will retire in the next five years, which is just one example of the challenges we face.
The lack of workforce capacity must be addressed to change survival outcomes for pancreatic cancer patients. It would be good if the Minister were able to update us on what his Department is doing to prioritise workforce planning and to provide the funding needed, based on England’s cancer workforce plan.
Fast access to quick and accurate diagnostic tests is also crucial. Many pancreatic cancer patients are diagnosed too late, when surgery—the only curative option—is no longer available. The early diagnosis inquiry by the all-party parliamentary group on pancreatic cancer, “Time to Change the Story,” heard anecdotal evidence from a healthcare professional that a CT scan can be done quite quickly but that the report can sometimes take 10 weeks. It would be helpful if the Department were able to respond to the recommendations of the all-party group’s report and to update us on the progress being made in that area.
The diagnosis of not only pancreatic cancer but other cancers, such as blood cancer, can be complex because symptoms such as back pain or tiredness are often misunderstood or misdiagnosed. Delays in blood cancer diagnosis can have a major impact on a patient’s quality of life and overall outcome, and earlier diagnosis would make a difference for many, but not all, blood cancers. To change this, recommendations for early diagnosis in the cancer strategy should be reviewed to ensure that all people with blood cancer are benefiting from early, accurate diagnosis. GPs could be encouraged to ask for a simple blood test for people displaying one or more blood cancer symptoms.
Diagnostic techniques also have the potential to guide what treatment options are likely to be effective. Last month, NICE provisionally rejected the use of five tumour profiling tests to guide treatment decisions on whether patients with a particular type of early breast cancer should also receive chemotherapy following surgery, reversing its previous guidance recommending Oncotype DX as an option. This goes to the heart of the point made by the hon. Member for Mid Norfolk (George Freeman) about using genomics effectively and precisely. Breast Cancer Now is concerned that this could be a backwards step for some breast cancer patients, especially in the context of the current cancer strategy’s welcome ambition to enable more personalised treatment.

George Freeman: Does the hon. Gentleman agree that on this subject of accelerated, earlier diagnosis and treatment, the work of the Institute of Translational Medicine in Birmingham, led by Professor Charlie Craddock, and the Cure Leukaemia team, working on blood cancers, has written the playbook on how we do early diagnosis? They have pulled in £200 million of free drugs for NHS patients by doing accelerated access.

Nicholas Dakin: There is some wonderful work going on, and this goes back to what the hon. Member for North Warwickshire (Craig Tracey) said about the need to grab this wonderful work and move it forward, and not be held back by frameworks that are not quick enough to move with the times.
The ability to personalise treatment based on tumour profiling, which would allow many women to avoid the gruelling side effects of chemotherapy, is an essential  part of improving patient care and has the potential to reduce costs associated with chemotherapy—that is a win-win. It can also give both clinicians and patients invaluable reassurance that they may safely not have chemotherapy, thus reducing overtreatment. NICE has not communicated clearly enough the reasons behind provisionally rejecting the future use of the Oncotype DX tumour profiling test, as it is unclear whether this is a result of additional clinical evidence, the cost or a combination of both. Will the Minister ask NICE to clarify the clinical and economic drivers behind the recent provisional rejection of tumour profiling tests to guide treatment decisions in a specific group of breast cancer patients?
The cancer strategy calls on Public Health England to continue to invest in “Be Clear on Cancer” campaigns to raise awareness of possible symptoms of cancer. Symptom awareness is a big challenge in terms of pancreatic cancer, as well as other cancers. A ComRes poll carried out by Pancreatic Cancer UK in 2017 found that 35% of adults in the UK would not be worried if they had a few of the potential symptoms of pancreatic cancer. Last year, Public Health England launched an exciting regional pilot on vague abdominal symptoms, including persistent diarrhoea, bloating and discomfort. Although the results for the campaign were positive, it has not yet been rolled out nationally. I would be keen to know when the Minister plans a national roll-out of the vague abdominal symptoms “Be Clear on Cancer” campaign.
In conclusion, much has been done and much is happening, but there is much more to do. Cancer alliances have a significant role to play in delivering effective change, and many are clearly making a difference. Workforce planning, early diagnosis and greater symptom awareness are key areas where we need to up our game as we move into the second half of this five-year cancer strategy.

Alister Jack: I, too, thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this debate. I would like to take this opportunity to discuss blood cancer in particular.
As many will know, there are different types of blood cancer, ranging from leukaemia, lymphoma and myeloma to the rarest blood cancers, which affect just a few people. Blood cancer is a complex and much misunderstood disease. According to Cancer Research UK, blood cancer is the third biggest cancer killer in the UK and the fifth most common cancer overall, with more than 230,000 people living with blood cancer. Compared with patients suffering from other cancers, those blood cancer patients had to see their GP significantly more times before being referred to hospital. More than 35% had to see their GP three or more times before referral, which compares with only 6% for breast cancer and 23% for other solid tumour types. According to the Office for National Statistics, blood cancer is by far the most common cancer among people aged under 30. Despite that, a number of issues with blood cancer still need to be addressed.
As the hon. Member for Scunthorpe (Nic Dakin) said, diagnosing can be very complex at times. Symptoms such as back pain or tiredness are often misunderstood and diagnosed as other conditions. Delays can lead to  major problems for patients in terms of not only their quality of life but the overall outcome. Recommendations in the cancer strategy for early diagnosis should be reviewed to ensure that all people with blood cancer benefit from early and accurate diagnosis. GPs should be encouraged to ask for simple blood tests for people displaying one or more blood cancer symptoms.
The cancer strategy says that all cancer patients will have had access to the recovery package by 2020. The package helps people, once their treatment has ended, to return to their normal lives. It includes a health needs assessment, care planning, health and wellbeing events, and a review of cancer care. However, the package is based around the needs of people with solid tumour cancers. In recent survey responses, people with chronic leukaemia, relapsing myeloma or lymphoma have said that terms such as “beyond cancer” and “post treatment” are not applicable to them. To ensure that people with blood cancer receive sufficient ongoing support, will my hon. Friend the Minister consider how all blood cancer patients can benefit from aftercare support, including by ensuring that the recovery package takes account of the unique characteristics of blood cancer?
Five thousand people a year with some slow-growing blood cancers are put on a regime of watch and wait instead of starting treatment straightaway. Their cancer is monitored for potentially many years before it has progressed to a point where treatment needs to start. Being monitored in this way can be difficult for many patients, and it can lead to psychological distress. Tailored psychological support must be made available to those patients on watch and wait.
Unlike with the treatment of solid tumour cancers, blood cancers are often not treatable through the use of surgery or radiotherapy. This means that blood cancer is more dependent on the development of new drugs and the ability to access them, and those things are very important if we are to continue improving patient outcomes. Continued Government investment in blood cancer research, including in clinical trials infrastructure, is required to capitalise on the UK’s position as a leader in blood cancer research. That will deliver benefits for patients, but it will also help the Government to reach the ambitions outlined in the UK life sciences industrial strategy.
The cancer strategy sets out how clinical leaders should work together in cancer alliances with those affected by cancer to decide how local care and services should be delivered. Despite this ambition, patients often find that services are fragmented, which adds stress to their experience. That can be a particular problem with blood cancer, because patients are often treated in haematology rather than oncology units. Cancer alliances should reduce fragmentation between the different stages of care for blood cancer patients by acknowledging and bridging the recognised gaps between oncology and haematology departments and between primary and secondary care.
To conclude, the cancer dashboard has been developed following a recommendation in the cancer strategy. It allows clinicians and others to compare performance of clinical commissioning groups and to identify areas for improvement. However, it covers only the four most common solid tumour types: lung, breast, prostate  and colorectal. That equates to less than half of all cancer cases. Will the Minister provide an assurance that the health service will actively work to include blood cancer in the cancer dashboard, as the fifth most common cancer, and to ensure that decisions about future services do not disregard these patients?

Thangam Debbonaire: It is a great honour to follow the hon. Member for Dumfries and Galloway (Mr Jack), who spoke so passionately and knowledgeably for better understanding, treatment and diagnosis of blood cancer.
Like everyone in the House, I could speak about many aspects of cancer, including my own experience. I could speak about the very moving speech made by Baroness Jowell in the other place—a very special moment in Parliament’s history, and one I will always be glad to have been there for, although I am very sad that she had to be there. I could speak about how horrible chemotherapy is and about how deeply a girl can feel the loss of her eyelashes, for example. I could speak about my support for health labelling for alcohol, as so few people are aware of the connections between alcohol and breast, bowel and other cancers.

Steve Brine: indicated assent.

Thangam Debbonaire: The Minister is nodding vigorously from a sedentary position, and I hope that means he will support better labelling.
I could speak about how important healthy habits are generally for reducing cancer, and again I ask the Minister to do more to urge people to take up those healthy habits from an early age. I could speak about how all women should learn how to check their breasts properly, because so many have told me that they do not how to do that. I could talk about what I learned last week in CERN, of all places, where the Large Hadron Collider is, about the contribution that that scientific institute has made to improving diagnoses of cancer. I could mention, for instance, the development of the MRI—the magnetic resonance imaging—machine. I spoke to scientists there who, I am glad to say, are doing what they can to reduce the very frightening knocking that happens when a person is inside the machine. However, today, I am going to speak about the patient experience of a very specific group—children and young people with cancer and their families.
I say to those children and young people, their parents, their brothers and sisters, their clinicians and the charities supporting them, who may be listening, that this speech is for you. I pay tribute in particular to CLIC Sargent and the Teenage Cancer Trust and thank them and all the other charities, too numerous to mention, that help children and young people with cancer every day. I want to give a very personal thanks to my sister-in-law Emilie, whose volunteering, fundraising and work for CLIC Sargent is an inspiration to so many and whose personal knowledge has taught me so much.

Mark Tami: I am a parent of a child who has had the support of CLIC Sargent. It is not only that the charity supports you from a medical point of view—the people you talk to actually understand what your child and you are going through.

Thangam Debbonaire: I thank my hon. Friend for that intervention. He is absolutely right: these specialist organisations understand not just what the patient is going through, but what the families are going through and how devastating a diagnosis can be. They also know what can be done to help people through it.
I set up the all-party parliamentary group on childhood and teenage cancer last year with the help of CLIC Sargent and the Teenage Cancer Trust, which provide the secretariat, because children and young people living with cancer and their parents told me that they want to have their voices heard in Parliament. I thank the officers, almost all of whom are here, for their work. I thank my hon. Friends the Members for Alyn and Deeside (Mark Tami), for High Peak (Ruth George), the hon. Members for Filton and Bradley Stoke (Jack Lopresti) and for Strangford (Jim Shannon) for their support.
Childhood cancers are, thankfully, rare. Just 4,000 children and young people under 25 are diagnosed with cancer each year in the UK, but this rarity means that they are very often difficult to diagnose and, therefore, much more likely than older patients to be diagnosed at emergency at a later stage. That also means that the treatment can be difficult and that children, young people and their parents have to travel a long way for specialist treatment. It can mean that treatment can be particularly and unpleasantly aggressive. There are consequences for children’s education and their future employment. The treatment may also affect their fertility—something that they may not even be thinking about at the time of diagnosis. It may cause a disability. It may set them apart from their friends at exactly the moment when they are just finding out who they are.
In Bristol, the Teenage Cancer Trust provides a specialist ward for teenage cancer patients—I thank everyone who works there. It is able to help teenagers and their parents to get through this difficult time with services that are tailored to their specific needs. CLIC Sargent provides specialist support, which, in Bristol, includes a home—not a house—for children and their families to live in and have care from while they are having treatment for cancer. Indeed, a parent I met when visiting the CLIC Sargent house told me of arriving in Bristol in the morning with nothing—apart from them and their child—expecting just a check-up, and by the evening discovering that their child had cancer and that the treatment was due to start immediately. The CLIC Sargent social worker in that case can explain what the house does and what the facilities are and help to guide people who are suddenly dealing with not only a really traumatising experience, but having no food, no clothes and no supplies for the next few days.
Two years ago, the “Cancer costs” report, the parliamentary launch of which I had the honour of hosting in autumn 2016, identified specific costs for families affected by childhood cancer. I urge the Minister to relook at that—I am sure that he has already seen it. Young people and parents at that launch told me that they wanted a voice, hence the formation of the all-party group. We are launching our first inquiry on Monday, looking at patient experience, and I know that the Minister will want to engage with that process as we go forward.
We want Parliament to better understand the really specific experience of children and young people with cancer and their families, and to identify whether their  needs are being met and where improvements can be made. For example, there might be suggestions for improvements to cancer diagnosis, post-treatment support, or help with the specific issue of the impact of the diagnosis that my hon. Friend the Member for Alyn and Deeside mentioned, as well as all the other areas that I have listed.
Many of us here may have had contact with children with cancer or their parents in our constituency work. I say to those people: this inquiry is for you, but it is also about you and with you. Young people, parents and professionals can get involved from Monday by filling in the short online survey on the all-party group’s Twitter feed and website. They can find out more about the inquiry on the webpage if they just google “APPG young cancer”. Our lines of inquiry are also informed by what children, young people and parents have already told us, and we have young people involved in hearing and analysing evidence as well as giving it.
The Government have committed to collecting patient experience data for the under-16s, and research into how that can be undertaken is progressing. We are pleased to hear about that data collection, but I would like the Minister to consider how it might be improved and tell us a bit more about that.

Mark Tami: A few years ago, CLIC Sargent produced a report about children with cancer returning to school. That really highlighted some of the major problems and the lack of guidelines to give teachers a proper understanding. Particularly for children who are very young, it is difficult not only for the child with cancer but for the other children at the school, particularly girls who have seen their friend, who looked perfectly normal, without hair, or something like that. It is a very difficult situation. We need a proper system in place so that those children can be properly included rather than excluded.

Thangam Debbonaire: My hon. Friend is absolutely right. I know from my experience in my own circle exactly how that can affect not only the young person but their educators. Young people have spoken to me of really different experiences. Some have said that they had good support from their school, while others have been told, rather sadly, that they were upsetting their peers with their hairlessness. I find that really challenging, because a child or a young person with cancer is actually an opportunity for schoolteachers to work with young people on how they can not only support their friends but reduce their own risk through making healthy choices at that point.
I reiterate to all hon. Members in the House and beyond that, if they would like to get involved with the all-party group or this inquiry, they should please get in touch with me. If children, young people, parents or other family members also want their voice heard in the inquiry or in Parliament, they can contact the group or me, or their own MPs. I hope that the Government, and Parliament generally, will be willing to hear the voices, needs and experiences of children and young people with cancer, and their families. I am sure that everyone here is committed to that, but we really must actually do it.

Michelle Donelan: I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this debate.  It is an honour to follow the hon. Member for Bristol West (Thangam Debbonaire) in her passionate and very well-informed speech.
We all have loved ones who have been affected by cancer. I lost my maternal grandparents to breast cancer and oesophageal cancer. Many in my family have suffered from melanoma, including my mother, and one of my friends is currently battling cancer. We have all heard harrowing stories from constituents. Cancer is indiscriminate: it does not care whether you are young or old, or someone’s mother or brother. Yes, we can make dietary and lifestyle changes to try to avoid it, and be aware of the symptoms, but advances in medicine mean that we can fight it more effectively and detect it earlier to increase the odds of survival, although there are still no guarantees.
Cancer survival rates are at a record high, with about 7,000 people alive today who would have not have been had mortality rates been the same as in 2010. This is a fantastic step in the right direction, but we are not at our destination. That is the point that I want to labour. For all those who lose their mother or child or friend today and hear of this debate, I want them to know that the Government, and all MPs, do “get it”. We get that we are on the right track, but equally that there is a long way to go, because cancer is still the most dangerous serial killer that remains at large in our communities. That is why we must continue to prioritise this area.
The formation of the £1.2 billion cancer drugs fund in 2010 was a massive step forward and has helped more than 95,000 people to access the life-extending drugs that they need, as was the implementation of the independent cancer taskforce’s strategy, seeking to save a further 30,000 lives by 2020. As I said, we are on the right track. In 2010, we had some of the worst survival rates in Europe, but we are now closing that gap. Last year, there were 7 million more diagnostic tests than in 2010, and 57,000 more patients started cancer treatment.
When it comes to cancer, prevention is key. I welcome the increased investment in cancer research by the National Institute for Health Research since 2010 and the work that the Government have done with Cancer Research UK, including a jointly funded network of 18 experimental cancer medicine centres aimed at driving the development and testing of new anti-cancer treatments.
I would like to draw attention to the high uptake of the HPV vaccination among teenage girls, which can prevent around 600 cancers per year and 99% of cervical cancer cases. I have spoken before in the Chamber on Public Health England’s tobacco control plan, which aims to usher in the first smoke-free generation by 2022.
Improving diagnosis is equally essential. Public health campaigns such as “Be Clear on Cancer” are vital to raise awareness of early symptoms, especially of less common cancers. Crucially, the £200 million that has been invested to ensure that patients receive a diagnosis or the all-clear within 28 days by 2020 will make a huge difference.
That would have benefited my constituent, whose symptoms were initially dismissed as irritable bowel syndrome. She then waited a long time for testing. She is now terminally ill with bowel cancer, but inspiringly, she is trying to work hard every day to raise awareness  and help others to get diagnosed quickly. Nearly everyone will survive bowel cancer if diagnosed early—in fact, nine in 10 people—yet shockingly and sadly, only 15% of people are diagnosed at that stage.

George Freeman: I thank my hon. Friend for giving way; she is making a powerful point. On early diagnosis, prevention and screening, the 100,000 Genomes Project that we launched here in the UK, focused on cancer and rare diseases, is seeking volunteers for genome sequencing to combine with patient data, to identify people at risk. That is a brilliant way for people to get involved, and if anyone is concerned, they should contact the NHS and enrol. We still need another 50,000 patients, and that is a marvellous way of getting access to early diagnosis. Does she agree?

Michelle Donelan: I thank my hon. Friend for making that point. Unfortunately, time does not permit me to cover that, so I am delighted that he has.
I welcome the new bowel cancer test, the faecal immunochemical test, known as FIT, which will be rolled out in April. It is more sensitive and accurate and can detect twice as many cancers as the current test. Currently only half of those invited to take part in bowel cancer testing do, but FIT is proven scientifically to increase the number participating in the programme, especially as it is easier and more hygienic to post than the current test.
However, new awareness of symptoms, coupled with the new test and the ageing population, is leading charities within the sector to voice concerns of a looming endoscopy workforce crisis. Bowel Cancer UK and Beating Bowel Cancer question the realism of getting 400 non-medical clinical staff by 2020 to carry out the 450,000 procedures, especially as only 48 have been trained so far. I would like to hear more from the Minister in response to that, so that my constituent can be assured that others may be diagnosed earlier than she was.
A key issue when it comes to beating cancer and preventing cancer is getting screened regularly when applicable. That is especially the case with cervical cancer. The NHS cervical screening programme in England offers screening to women aged 25 to 49 every three years and women aged 50 to 64 every five years. Every year in the UK, around 3,000 women are diagnosed with cervical cancer, but research shows that the number of women using the service has dropped to a 20-year low, with more than 1.2 million not attending their screening in the last year. A recent report by Jo’s Cervical Cancer Trust showed that embarrassment is a key barrier to attendance for between a third and a half of all women, as is the desire not to miss work. There is also a severe lack of understanding about the importance of screening. Shockingly, one in three women aged between 25 and 29 miss their smear, yet cervical cancer is the most common cancer for women under 35. We must address this.
I note that Imperial College has conducted a trial to assess the effectiveness of texting non-responders to improve coverage, but I think that we should just do this—it can only help. I also welcome the fact that the Department of Health and Social Care’s behavioural insight team has undertaken a trial to investigate the use of behavioural insights to optimise the content of the invitation letter for cervical screenings.
I must admit that I was one of these women: I put off my screening for years. I left it at the bottom of my to-do list until I could fit it in around my job, and it just kept slipping year on year. I must admit, if I am honest, that I really did not realise that cervical cancer is most common in women under the age of 35. When I did have my screening, I had to go through the processes necessary after abnormal cells show up. As my results showed high grade abnormalities, I am extremely thankful that I went when I did. I want to take this opportunity to praise the work of Jo’s Cervical Cancer Trust, which provides women with information and support, which I found extremely helpful.
We seem to be very British about cervical smear tests. We do not really like to talk much about them, and that does not promote women going for them. Yes, it is not nice—it hurts a little, it is awkward and a bit embarrassing —but it could save your life. That is the message we need to get out. We need to promote cervical screening from school age, so that women recognise all the risks and the importance of going from age 25.
In September and October 2017, Jo’s Cervical Cancer Trust sent freedom of information requests to all upper-tier and unitary local authorities and clinical commissioning groups in England to ask what activities they had undertaken to increase cervical screening coverage from August 2016 to August 2017, along with the outcomes of those activities. Of the 149 local authorities that responded, 32% had not undertaken any activities at all. I ask the Minister to commission a review—and to adopt a strategy to increase the falling rate of cervical screenings—looking at availability and the challenges of reaching all women, and at the need for awareness of cervical cancer.
To conclude, Macmillan claims that, by 2020, 47% of people will get cancer at some point in their life, which is almost one in two. That is the scale of the problem we face. While we have come so far since 2010 in terms of diagnosis and treatment, there is still so far to go.

Karen Lee: I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for bringing about this debate, which matters hugely to a lot of people.
Most of the speakers today will talk about the facts, figures and statistics, but I will talk about the impact of cancer on people behind the statistics. A lot of us in the Chamber have been affected by cancer. My daughter died at just 35 of breast cancer, and I will talk about cancer from a patient’s perspective. One in eight women develop breast cancer in their lifetime, and 80% survive for five years or more. About 95% of women will survive for one year, and my daughter survived for 13 months. Recent data show that 11,500 women and 80 men in the UK still die from breast cancer every year.
My Lynsey was diagnosed with triple negative breast cancer in April 2010, and she died just 13 months later. She was a very bright girl, with a degree in politics and a degree in social work, and she worked with underprivileged children. She had a husband and three small children, who were two, four and seven when she died. She was treated at Nottingham City Hospital under Dr Steve Chan—she had chemotherapy, radiotherapy and a mastectomy—and her treatment was just amazing. The staff just could not have been better. She came home for  the final three weeks of her life to die, and the unqualified team that came in to support me and her husband, Mike, were just amazing as well. I can never thank them enough.
I want to talk a little about the information that Breast Cancer Now, a charity, has made available to me. I am an ambassador for it, because I decided that one of the things I wanted to do when I got elected was to be an ambassador for a breast cancer charity. It has said that
“it will be challenging to meet the objectives set out in the Cancer Strategy unless corrective action is immediately taken”.
My Lynsey’s cancer was advanced—it was stage 3 when diagnosed, so screening probably would not have helped her. The Breast Cancer Now report states:
“Breast screening is a key initiative to ensure the early detection and diagnosis of breast cancer. Although controversy still exists around over-diagnosis, its benefits are recognised to outweigh its risks in the Cancer Strategy, in detecting 30% of breast cancers and saving 1,300 lives a year from breast cancer.”
The report also talks about a shortage of staff—32% of radiologists are expected to retire between 2015 and 2025.
My daughter developed a brain tumour—a common secondary effect of breast cancer—and she had to go for radiotherapy. It is truly traumatic. She used to see flashing blue and white lights; she had to wear a mask. The really upsetting thing was that because of staff shortages, she often had to lie around on a trolley waiting for things. Imagine what it is like laying on a hospital trolley with cancer in your bone and metastasis—it is just so distressing. That is the effect on patients of short staffing. It is just a phrase in a report, but that is what it really means.
Breast Cancer Now’s report states:
“We are also concerned about the lack of access to Clinical Nurse Specialists for secondary breast cancer patients: only 21% of organisations in England, Scotland and Wales report having one or more CNS dedicated to secondary breast cancer. We know that access to a CNS can make a big difference to the way people with cancer experience their care, providing patients with support and helping them manage their symptoms. This is especially important for patients—
those like my Lynsey—
“with incurable secondary breast cancer who have particularly complex needs.”
Finally, Breast Cancer Now also said:
“We have serious concerns about the future of the National Cancer Patient Experience Survey as a result of the introduction of a new opt-out model scheduled in May 2018. The CPES has been a key driver of the improvements in cancer patient outcomes and experience since 2010.”
It is the aspiration of Breast Cancer Now that by 2050, everybody who develops breast cancer will live. I used to say to my daughter, “I’ve had so much of my life, more than you. I wish it could be me.” She used to say, “Mum, I wish it could be no one.” As parliamentarians we have power to influence things and change them, so perhaps we can join together across the House and make Breast Cancer Now’s vision a reality, so that by 2050, nobody need die of breast cancer.

Grahame Morris: I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for opening this debate on behalf of the  hon. Member for Basildon and Billericay (Mr Baron), and I pay tribute to his excellent work over many years as chair of the all-party group on cancer. I am delighted to support this debate, and as someone who has always taken a key interest in cancer strategy, I wish to highlight three issues. Pancreatic cancer has been well covered by my hon. Friend the Member for Scunthorpe (Nic Dakin), so I will refer to it only briefly. I also want to mention transformation funding and make a plea to the Minister, and I will say something about advance radiotherapy—a hobbyhorse of mine.
As hon. Members may be aware, I have recently recovered from a reoccurrence of lymphatic cancer, so I have first-hand knowledge of the importance of getting the cancer strategy right, not least in terms of early diagnosis and appropriate treatment. Delivering the recommendations set out in the cancer strategy is crucial to improving care and support for thousands of people affected by cancer. I do not seek to make a party political point about the nature of that policy, but essentially it requires resources, a plan, a strategy and commitment.
Sadly, pancreatic cancer has taken friends of mine, and it is particularly nasty. It has the worst five-year survival rate of the 20 most common cancers at less than 7% across the UK—a figure that has hardly changed over the past 40 years. In most other types of cancer, survivability has gone up. For pancreatic cancer, however, it has remained fairly flat. We urgently need investment and action, because pancreatic cancer is set, on current trajectory, to become the fourth biggest cancer killer by 2026. Currently, 80% of pancreatic cancer patients are diagnosed at the stage where the disease is advanced. Surgery is the only potential curative treatment, but sadly it is not an option when the disease is at an advanced stage. As far as I am aware, pancreas transplants are not an option. Early diagnosis is therefore absolutely key to improving the appalling survival rates and ensuring that patients are able to live longer following diagnosis.
I looked up the figures for my own area. Between 2010 and 2014, pancreatic cancer took the lives of 188 people in the Easington, Durham dales and Sedgefield clinical commissioning group area. It is clear that much more work is needed to deliver the kind of change we must see for the people affected, and their families, so we can achieve the improvements in survival rates that are so desperately needed.
Not long ago, I had the pleasure of visiting a local National Citizen Service group of young volunteers in my constituency—I think many Members have taken similar opportunities. The House might be interested to note that one group of young people were raising money for a chemotherapy ward because of their personal and family experiences. They thought that the facilities available were inadequate. This was because the ward, although filled with excellent and committed staff, was grappling with an increase in demand and a lack of funds. These young people raised enough money to buy an assortment of things, including floor fans to keep the patients cool. It is an indictment that, when we are putting additional money into the recovery fund and encouraging people to get through the treatment and to go on, we are relying on charitable donations.
At the Britain against Cancer conference 2016, the chief executive of NHS England announced £200 million of funding for treating cancer, along with improving early diagnosis and funding stratified pathways. The money was intended to support the roll-out of the recovery package. However, since this transformation funding was announced, there have been significant delays in its reaching cancer alliances, with only nine of 16 alliances having received funding. At the Britain against Cancer conference in December 2017, the Secretary of State for Health said that the release of funding to cancer alliances would be delayed in areas that were unable to demonstrate an improvement in their 62-day waiting time standard. That was an additional requirement that had not been included as part of the original criteria set during the bidding process.
Every person diagnosed with cancer—it does not matter where they live—should be able to rely on timely diagnosis and treatment when they are told they have cancer. However, as the final report from the all-party group on cancer’s inquiry concluded, the delayed release of funding to the cancer alliances has had a significant impact on their ability to make progress. I hope the Minister is paying attention, because I want to ask him a question.

Steve Brine: He is.

Grahame Morris: I am very glad to hear it, because this is a serious point. The Department of Health and Social Care must decouple the release of transformation funding to cancer alliances from progress against the 62-day waiting time standard. I hope the Minister will address that point in his remarks. [Interruption.] I look forward with anticipation to his remarks.
It would not be a contribution on health from me if I did not mention advanced radiotherapy. I have raised regularly its benefits and advocated further investment in its research. Investment and research, given the cost, should be evidence-based, but there are some really quite exciting areas: in particular, proton beam therapy—I visited University College Hospital in London for part of my treatment and saw the installation of the proton beam therapy bunker and equipment there; stereotactic ablative body radiotherapy; adaptive radiotherapy based on advanced imaging—a kind of magnetic resonance linear accelerator; combinations of radiotherapy and novel drugs; biomarkers with selections for altered radiotherapy strategies so that radiotherapy can precisely target the cancer cells; and molecular radiotherapy. It is necessary that we evaluate the use of these new radiotherapy techniques and compare them with conventional radiotherapy and some surgical techniques, as radiotherapy is sometimes more effective than surgery and pharmaceutical products. I am advocating that they be used not instead of, but alongside other treatments and following considerable evaluation. This could result in better outcomes and reduced treatment costs.
Finally, I would like to thank all my colleagues on the all-party group on cancer, the cancer charities that continue to do excellent work and all those in our national health service working in cancer prevention and treatment.

Jim Shannon: I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing this debate, and I am grateful  to hon. Members for their extremely touching, wonderful and very personal contributions. As everyone here can testify, cancer has touched everyone—no family will not be aware of it. In fact, it is said that by 2020 one in every two people will be diagnosed with cancer in their lifetime. My father had cancer three times and each time survived, owing to the skill of the surgeon, the care of the nurses and the prayers he clearly believed in.
We have many problems in Northern Ireland—we all know about the political process—and I am conscious that health is a devolved matter, but I wonder if the Minister could have discussions and co-ordinate with the permanent secretary in the Department of Health, Richard Pengelly, to see if he can help and encourage his Department with the problems facing it. The incidence of cancer in Northern Ireland has increased by 25% in the past 10 years, such that the number of cancer cases each year has reached 9,000 for the first time. That is an indication of the problems.
I thank the many organisations, particularly Macmillan Cancer Support, for the information they have provided to us. There are 2.5 million people living with or beyond cancer in the UK today. The issue is that not all of them are living well: many experience physical, emotional and financial consequences as a result of their treatment. One in four face disability or poor health following their treatment that can persist for many years after treatment has ended, despite the NHS being set up to meet the changing needs of cancer patients and to enable access to the best treatment that is right for patients.
Macmillan is even more conscious of, and concerned about, the financial implications. According to projections in the “Five Year Forward View”, expenditure on cancer services is set to grow by 9% each year, which gives us an idea of some of the issues and takes us back to some of what was said earlier about prevention—I think that the hon. Member for Bristol West (Thangam Debbonaire) and others referred to prevention. We have had cancer patient experience surveys in Northern Ireland for a while now, and it is important that we are able to see what the trusts and CCGs are doing, what the cancer types are and the different aspects of the cancer journey. In England, the cancer patient experience survey has been happening since 2010 and has been proven to encourage hospitals to implement changes in order to improve results. That is very important.
I would be very pleased if the Minister could come back to us on the following point. Macmillan is concerned that the NCPES will not continue to deliver the same high-quality data, as the current survey model is not likely to be viable under the terms of the national data opt-out model that is scheduled to be introduced in May 2018. It is clear that Macmillan care has concerns. We have collected all the data and all this information through the clinical commissioning groups. The continuation of the cancer patient experience survey in its current format with high-quality, robust data is vital across the whole United Kingdom of Great Britain and Northern Ireland. Again, will the Minister provide the clarity that is needed on the issues that have been outlined on the NCPES to ensure the continued delivery of this essential and robust patient survey? The benefits are there in the data. I thank him for that.
About one in eight people diagnosed with cancer face mental health problems, such as anxiety, depression and post-traumatic stress disorder. Planning is needed to  ensure that everyone living with cancer across the whole United Kingdom of Great Britain and Northern Ireland can access the right care and support, whether that means information, financial assistance, vocational rehabilitation or emotional support. Families can give so much of that emotional support, and they do so gladly, but at the same time we need to reach outside that.
Just 68% of people with cancer in Northern Ireland started treatment within 62 days of referral. Again, I am very much in the early diagnosis category and we need that in place. Cancer deaths in Northern Ireland are at the highest level that they have ever been. My party is totally committed to improving the five-year-survival rates and believes in targeting resources to tackle deprivation, which is another issue. There is a higher level of cancer incidents where there is deprivation.
More needs to be done to provide good continuity of care and to ensure that all patients have supported access to key information about their condition, treatment options and the types of support that are available. Macmillan is funding a second Northern Ireland survey that will be launched in spring 2018. It has invested £7 million in the Northern Ireland specialist cancer nursing plan, because this vital segment of the cancer workforce is not keeping pace with demand. Macmillan recognises that there are shortcomings and it has tried to introduce finance where it can to ensure that things go the right way.
Cancer is the most common cause of death in Northern Ireland. The end-of-life choice is very important. The Northern Ireland cancer registry found that 75% of patients would prefer to die at home. That subject matter is not easy to speak about, but the fact is that this needs to be looked at. Macmillan’s research found that people are more likely to die in the place of their choice when their wishes are recorded and known by their healthcare. We believe that a new cancer strategy should include commitments to improving end-of-life care and giving everyone who is diagnosed with cancer the opportunity to have advance care planning discussions.
Macmillan has made a number of recommendations, which I will conclude with—it is referred to as the “Delivering Together” strategy. I totally support Macmillan’s reforms, such as producing a detailed implementation plan, including specific actions to improve care and support for people living with cancer and to enhance the patient experience in all trusts and CCGs. It recommends making the recovery package available to everyone living with and beyond cancer, the timely adoption and implementation of NICE guidelines to improve cancer detection, treatment and support, and close working with GP federations to ensure that care is provided closer to home.
The recommendations include long-term cancer workforce planning, integrating health and social care with higher education to attain a more knowledgeable and skilled workforce—it is important to have that—and with effective recruitment and succession across disciplines and settings. They include the better integration and co-ordination of all those things as well, including signposting to the non-clinical support that patients need at each stage of their cancer journey, and providing high-quality palliative end-of-life care in all settings on a 24/7 basis. That should begin with cancer patients having the option of advance care planning conversations  at the earliest possible stage. The recommendations also include increasing the involvement of people affected by cancer in the development, redesign and delivery of services and a commitment to ongoing routine use of data collection tools, including the cancer patient experience survey and the peer review programme, to identify any gaps or inequalities in cancer care and pinpoint areas for improvement locally and benchmarking across the UK.
I ask the Minister to take on board all the issues we have all referred to and to do what can be done to help the massive amount of cancer sufferers across the whole United Kingdom of Great Britain and Northern Ireland so that they have a better journey, a better outcome and better support.

Ronnie Cowan: I thank the hon. Member for Basildon and Billericay (Mr Baron), who cannot be with us today, for being proactive in securing the debate this afternoon. I also thank my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) who stepped in to open the debate in his absence. She raised concerns about targets not being met and the resources available to meet those targets, and reminded us all that those in receipt of treatment must be involved in the ongoing conversations. Their experience is vital in improving the process as we go forward. It is imperative that we improve end-of-life care to offer the dignity that is appropriate at that time.
The hon. Member for Bosworth (David Tredinnick) spoke eloquently about alternative therapies and the role they can play. I would include in that category—although I am not putting words into his mouth—the investigation into the use of medicinal cannabis. The hon. Member for Coventry North East (Colleen Fletcher) focused on post-stem cell transplant care and the practical support that is required, and also asked whether we could review the 100 day cut-off date.
The hon. Member for North Warwickshire (Craig Tracey) spoke about breast cancer, the UK’s most common cancer, with a survival rate that has doubled in the past 20 years. He went on to highlight the question of dense tissue, something that was new to me, and the need for early diagnosis, and he called for better education in this area.
The hon. Member for Scunthorpe (Nic Dakin) put out challenges about pancreatic cancer. Although progress has been made, this seems to be an area in which minimal progress has been made over the years. He drew attention to the workforce programme and asked whether NICE could possibly clarify some of its decisions.
The hon. Member for Dumfries and Galloway (Mr Jack) focused on blood cancer and the complexities around diagnosis, and called for continued clinical research. The hon. Member for Bristol West (Thangam Debbonaire) spoke about young people and cancer, and the role played by CLIC Sargent. Today I am proudly wearing my Glow Gold ribbon, given to me by a young man in my constituency this time last year.
The hon. Member for Chippenham (Michelle Donelan) highlighted the desire that the Government prioritise cancer research. We have come a long way, but we still have a long way to go. She also highlighted the need for early diagnosis, a recurring theme this afternoon. The hon.  Member for Lincoln (Karen Lee) spoke movingly about the people behind the statistics, including her own daughter. She also highlighted the reality of staff shortages and what they mean for patients.
The hon. Member for Easington (Grahame Morris) spoke of his first-hand knowledge of overcoming cancer and, as many speakers have said, survivors’ experiences should be hugely influential when developing better treatments. Who could possibly have a better understanding?
The hon. Member for Strangford (Jim Shannon) mentioned that every family is struck in some way by cancer. He also mentioned the financial implications, and I shall take up that topic later.
Despite our progress cancer remains a lingering, stubborn foe and as policy makers we have to support our respective health services as they seek to improve the treatment that patients receive. We have undoubtedly taken great strides and our progress from a historical perspective is one of steady improvement, but for individuals, months, weeks and even days become precious as they grapple with the uncertainties that this illness brings to their life.
While patients come to terms with the emotional and physical impact of their diagnosis they must also continue to manage the everyday practicalities of life. Chief amongst these is finances, and research commissioned by Macmillan Cancer Support shows that four out of five people with cancer are, on average, £570 a month worse off as a result of their diagnosis. I believe we can improve that situation by introducing a duty of care for financial services as that would allow cancer patients to have increased flexibility when dealing with organisations such as their bank.
It is clear that more needs to be done to give cancer sufferers greater security. The introduction of flexibility of mortgage payments, interest freezes on credit cards or signposted financial advice to avoid problem debts are just some of the ways in which banks may be able to assist. I would therefore encourage the UK Government to strongly consider the introduction of a legal duty of care as a matter of urgency so that those recovering from cancer are afforded greater support.
I hope that, where possible, the different health services across the United Kingdom have satisfactory measures in place for the sharing of best practice. The Nuffield Trust, for example, concluded in a 2017 report that Scotland had a unique system for improving the quality and safety of patient care, and that other health authorities in the UK could benefit from the approaches used in Scotland. Mark Dayan, the lead author of the report, stated that Scotland had
“worked on getting its healthcare services to co-operate for longer than the other nations of the UK. So we’re urging healthcare leaders from England, Wales and Northern Ireland to think about what elements they might want to import from Scotland.”
I am sure that those in the Scottish NHS will be watching with interest as the NHS in England continues to implement the Cancer Taskforce’s five-year strategy for cancer care. Shared knowledge is a vital tool for future progress.
Earlier this year, I hosted the world cancer day drop-in event, along with the hon. Member for Cambridge (Daniel Zeichner). It was heartening to listen to Cancer Research UK’s ambassadors, and to reflect on the many unsung heroes who assist cancer sufferers or have experienced cancer themselves. I hope that the Government  are listening to those in the third sector, because through their effort and commitment they have gathered a huge amount of valuable knowledge.
The hon. Member for Dumfries and Galloway talked about blood cancer, and the hon. Member for Bristol West talked about cancer in children. I want to combine the two by telling a story about a young man from my constituency—a very brave young man called Nathan Mowat. Nathan is now at the ripe old age of seven. With the love and support of his mum Gillian, dad Paul and sister Annabel, he has completed three years of treatment for lymphoblastic leukaemia, which he can pronounce a lot better than I can. He has experienced 10 different cocktails of chemotherapy, six bone marrow procedures, three surgeries, 22 lumber punctures, and 16 blood and platelet transfusions. Nathan earns a “bead of courage” for every procedure that he goes through. He has earned 1,500 “beads of courage”. Where Nathan and other brave children have led, others will follow.
I hope that all Members will join me in reaffirming our commitment to three actions: considering legislation that will help to support cancer patients in different aspects of their life, including their personal finances, giving our health services the financial support that they require, and ensuring that the expertise and knowledge of academia around the globe are fully utilised to formulate Government policy.

Sharon Hodgson: I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for leading the debate and for her excellent speech, and I thank the hon. Member for Basildon and Billericay (Mr Baron) for securing the debate. He is not in the Chamber, but I also want to thank him for the excellent contribution that he has made to the work of the all-party parliamentary group on cancer for many years. His expertise and passion about this matter are what has made the APPG so successful.
I also thank the other Members who have made excellent speeches about this important issue. I thank the hon. Members for Bosworth (David Tredinnick), the hon. Member for North Warwickshire (Craig Tracey), with whom I co-chaired the all-party parliamentary group on breast cancer—he raised the important issue of breast density, which, as he said, is an issue on which we really do need to make progress—the hon. Members for Dumfries and Galloway (Mr Jack) for Chippenham (Michelle Donelan), for Strangford (Jim Shannon), and for Inverclyde (Ronnie Cowan), the Scottish National party spokesman. I thank my hon. Friends the Members for Coventry North East (Colleen Fletcher), for Scunthorpe (Nic Dakin), and for Bristol West (Thangam Debbonaire), and my hon. Friend the Member for Lincoln (Karen Lee). She is no longer in the Chamber, but she made a powerful and emotional speech about her daughter, who would be so proud of her bravery today—as, I am sure, her grandchildren will be. I hope that the whole family were watching the debate today. I also pay tribute to my hon. Friend the Member for Easington (Grahame Morris), who, I think, has fought cancer twice.

Grahame Morris: Three times.

Sharon Hodgson: It is an absolute pleasure to see my hon. Friend in his place. Long may he stay there.
Cancer is, understandably, a very emotional topic. One in two people in the UK will be affected by cancer in their lifetimes, and, as we have heard from almost everyone who has spoken today, we have all been affected in some way ourselves. When my children were very small, I lost my mother-in-law to breast cancer. That is one of the reasons why I joined the all-party parliamentary group on breast cancer, and I am vice-chair of the group to this day. It is this emotion that encourages us and gets us all to come together to tackle cancer.
Over the years there has been a steady improvement in cancer survival rates in England. However, we still lag behind the improvements of our European counterparts, and the number of new cancer cases continues to rise year on year. If these trends continue it is estimated that by 2020 some 2.4 million people in England will have had a cancer diagnosis at some point in their life. That is why the Government must take urgent steps so that cancer diagnosis care and outcomes in England can be improved.
The cancer strategy was a welcome step forward to achieving the best cancer care and outcomes in the world, and Labour is fully committed to delivering, and helping to deliver, that strategy in full. However, as has been mentioned, there are some concerns across the House about the progress of the strategy. I am pleased that some of the targets have already been met, but I am under no illusions—many are no closer to being reached than they were almost three years ago. Will the Minister today commit to publishing a detailed progress update on each of the 97 cancer strategy recommendations by the end of this financial year, so we are all able to celebrate success but also focus our attention on more pressing challenges where needed? There are many challenges that the Government must face before achieving world-class cancer outcomes, but I will touch on only a few today: early diagnosis; waiting times; the workforce; and prevention.
On early diagnosis, we know that if a cancer is diagnosed early, treatment is more likely to be successful, but for cancers such as ovarian cancer and lung cancer it is often too late. The National Cancer Registration and Analysis Service found that over a quarter of women with ovarian cancer are diagnosed through an emergency presentation. Of those women, just 45% survive a year or more, compared with over 80% of women diagnosed following a referral by their GP. I should state at this point that I am chair of the all-party group on ovarian cancer. Similarly, research by the British Lung Foundation found that more than a third of lung cancer cases in England are diagnosed after presenting as an emergency. As a result, the Roy Castle Lung Cancer Foundation found that, if caught early, a person has up to a 73% chance of surviving five years or more. However, the current five-year survival rate for lung cancer is just 10% and, sadly, one in 20 lung cancer sufferers was not diagnosed until they had died. Cancer survival rates have doubled over the last 40 years, but those are shocking statistics. I therefore ask the Minister what his Department will be doing to ensure that cancers are detected even earlier, so that patients are no longer pushed from pillar to post trying to find a diagnosis.
Unfortunately, we know that once a patient has been diagnosed, they then have an agonising wait for treatment. Even if it was a wait of just a week it would be agonising, but the 62-day target between urgent GP referral and treatment has not been met now for two years,  meaning that patients are having to wait much longer than they should for treatment. Since the target was first breached in January 2014, over 95,000 people have waited for more than two months for treatment to start. Cancer patients should not be expected to wait so long. I therefore ask the Minister, what his Department is doing to address this issue.
It is no secret that the NHS and the NHS workforce are under extreme pressure due to underfunding and understaffing by this Government. I want to place on record the fact that Labour Members do not take the NHS workforce for granted. We are incredibly grateful to them for their hard work, support and kindness to patients and their families. They are doing an incredible job despite the circumstances we currently find ourselves in, and we should never stop thanking them for the work they do to diagnose, treat and care for patients. The cancer workforce really are the backbone of the cancer strategy.
The improvement of early diagnosis and waiting times relies on an efficient cancer workforce, so the Minister must make these concerns a top priority if the targets in the cancer strategy are to be fulfilled. A report by Macmillan Cancer Support found that more than half the GPs and nurses surveyed in the UK say that, given current pressures on the NHS workforce, they are not confident that the workforce are able to provide adequate care to cancer patients. That is deeply worrying. The NHS workforce should be suitably equipped to diagnose, support and care for cancer patients, during and beyond cancer.
Through my work with the all-party parliamentary group on breast cancer, I have heard—as I am sure the Minister did during his time as the group’s co-chair—of the overwhelming support that a cancer nurse specialist can bring to breast cancer patients and their families. As we have heard, however, patients with secondary breast cancer are unlikely to have access to a cancer nurse specialist. Research from Breast Cancer Care shows that 42% of hospital trusts and health boards in England, Scotland and Wales do not provide dedicated, specialist nursing care for people with secondary breast cancer, even though they often have complex emotional and supportive care needs. Patients with secondary breast cancer are subject to a postcode lottery when it comes to having a cancer nurse specialist. What steps is the Minister taking to ensure that every cancer patient has access to a clinical nurse specialist?
There is no doubt that, if the cancer workforce had the time, resources and support they so desperately need, the recommendations in the cancer strategy would be achieved. I know that that is something the cancer workforce plan, published in December last year, aimed to address. Will the Minister update the House on the progress of the plan, and outline how much funding the Government will be granting to ensure that the proposals in the plan soon become a reality? The NHS cancer workforce care for and support their patients every day, and we really need the Government to support the workforce, too.
Finally, I move on to the first issue raised in the cancer strategy: prevention. The World Health Organisation estimates that a third of deaths due to a cancer are the result of the five leading behavioural and dietary risks:  high body mass index; low fruit and vegetable intake; lack of physical activity; tobacco; and alcohol. The subject of alcohol was raised by my amazing hon. Friend the Member for Bristol West. Tobacco was identified as the most important risk factor, responsible for approximately 22% of cancer deaths. Taking all five risk factors into account, it is estimated that between 30% and 50% of cancers could be prevented.
The Government’s tobacco control plan—which the Minister thankfully pushed to be published in his first weeks in the job—and the childhood obesity plan are welcome steps towards reducing the high rate of preventable cancers, but they will not go far enough if the Government continue to slash public health budgets. Will the Minister therefore commit to strengthening public health budgets so that fit and healthy lifestyles can be encouraged across all our communities and help to contribute to cancer prevention? I know that, like me, he is passionate about making sure that England is one of the world leaders when it comes to cancer outcomes, but we are currently lagging behind. However, with the right funding and support from the Government, the cancer strategy has the potential to achieve that. I hope that he will take on board all that we have heard today and go back to his Department with an action plan of how best to move forward so that we can really achieve world-class cancer outcomes in 2020.

Steve Brine: I should like to thank my friend the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), for her remarks. I congratulate the members of the all-party parliamentary group on cancer on securing the debate, in particular the hon. Members for Scunthorpe (Nic Dakin) and for East Kilbride (Dr Cameron)—I shall leave it at that in describing the hon. Lady’s constituency, lest I make a total fool of myself. As the cancer Minister—Members will know that that is the job I always wanted to do—I thank them for the constant work they do on the all-party group and on the Britain Against Cancer conference. Linked to that, I want to extend my appreciation to the Members on both sides of the House who chair the all-party parliamentary groups on different kinds of cancer for the work they do. Some of them are here today. As has been mentioned, I was a co-chair alongside the shadow Minister and the previous Member for Mid Dorset and North Poole and we were quite a team. We were often referred to as Steve and the girls—I found my inner girl. We chaired the group together for five years and I was so proud to do that. We met some amazing people and I think we did some good.
With the shadow Minister, I was also vice-chair of the all-party parliamentary group on ovarian cancer—she still chairs that group—so I know how important it is that Parliament allocates time for this subject, both upstairs in the APPGs and here in the Chamber. Looking at how many people are in the Public Gallery and around the Chamber, this is about quality more than quantity. I say to those watching today who may say, “This is a debate on the cancer strategy. This is so important. Why isn’t the House as full as it is for PMQs?”—this is not all about what goes on in here. This is about what goes on in Government, what goes on upstairs in the APPGs and Select Committees and, for so many Members, what goes on within ourselves.  I did not know the shadow Minister’s motivation for chairing the APPG. I have never said my motivation—I will one day—but I realise now why she was so passionate.
The hon. Member for East Kilbride pretty much summed things up in the first line of the first speech of this debate when she said that we are all “on the same side” when it comes to cancer—what a brilliant way of putting it. The hon. Member for Coventry North East (Colleen Fletcher) talked about her husband, who lives with cancer. Macmillan has been brilliant with some of its communications, and we have all seen the television adverts saying that a mum with cancer is still a mum. There are so many people who are living with and beyond cancer—they call it “survivorship” in America—and we should always remember that.
Let me start by reassuring the House, if I need to, that cancer is a huge priority for me, for the Secretary of State and for this Government. As several Members have said, cancer survival rates have never been higher, and the latest survival figures show an estimated 7,000 more people surviving cancer after successful NHS cancer treatment compared with three years prior. Our aim is to save 30,000 more lives by 2020 through the cancer strategy that we are debating.
However, I know more than anybody that there is still so much more to do and so much potential, which is why we accepted all 96 recommendations in the cancer strategy. We have backed that commitment with over £600 million of additional funding up to 2021. We are now just two years into the implementation of the strategy and the fantastic NHS cancer doctors and nurses supporting us to achieve our vision have made tremendous progress in many areas. I echo what many Members have said in their support.
The shadow Minister and others asked whether I will report back on how we are doing on all of this. In October, NHS England published its “two years on” report on the day that I gave evidence to the all-party parliamentary group on cancer’s inquiry, which led to its report and to this debate. That was our latest progress report, and I hope that we will be doing something again later this year. NHS England’s national cancer director, Cally Palmer, who is based at the Royal Marsden Hospital and is an incredible lady with whom I enjoy working, is leading the implementation of the strategy. She agrees with me that there are many areas where we agree with the APPG’s report. We do not shy away from scrutiny, which is exactly why we are here. However, progress in many areas was not given sufficient prominence in the APPG’s analysis of progress. We said that at the inquiry. It is important that I put that on the record.
The measure of the strategy’s success will of course be about significant improvements in early diagnosis, which I will come on to, and obviously treatment and research. However, I am increasingly aware in this job that we need to make cancer services even better beyond 2020 and that there needs to be a greater focus on a fourth pillar— the “fourth Beatle”, if you like—which is prevention. Of course, we want to be the best in the world at delivering positive outcomes for patients after a diagnosis, but we have to understand the position. Earlier this week, I responded to a Westminster Hall debate attended by Members from Oxfordshire. There has been a 120% increase in the number of people presenting with cancer in Oxfordshire alone in recent years.
The number of people presenting with cancer continues to rise. We can do very well on the first three pillars, and we are, but prevention is where we will really move the dial. That is why my whole mission as the Minister for primary care and public health, a role created by this Health Secretary, has been to put in place a comprehensive system of measures to reduce the risk of cancer, as well as to treat cancer when it occurs.
As my hon. Friend the Member for Chippenham (Michelle Donelan) and the shadow Minister mentioned, one of my first acts as Minister was to launch the tobacco control plan. Why was I so keen to get it out there? Because we promised we would, but also because tobacco is the biggest preventable killer in our country today. The previous Labour Government and this Government have done well with the legislative framework. It is now about supporting local areas to continue bringing down the number of people who smoke from what are already record lows and to ensure that people do not start smoking in the first place.
Last year we also launched a cross-Government air quality plan, which has been in the news and in the House this week. That plan is important, too, because it will significantly reduce the carcinogens in the air we breathe, which we know has a big impact on the development of disease. Furthermore, in 2016 we published our child obesity strategy, which was just the start of a conversation about how we will reduce child obesity over the next decade. Our overarching focus in all that work is to ensure that our children are supported to live healthy, active and happy lives so that they grow into healthy, active adults who are less likely to develop cancer. We have always said that the child obesity strategy is constantly under review—it is part one—and we will go further, if needed, to build on that.
As has been mentioned a few times in this debate, perhaps the biggest game changer in preventing cancer is the world-leading work on genomics happening in our country. The chief medical officer’s 2016 annual report, “Generation Genome,” which was published the year before I was appointed, set out the huge potential for genomics in helping us to understand the inherited and acquired genomic causes of cancer and in shaping future research and future personalised cancer treatment, which is so important—it is something we should talk more about, as we should the whole prevention agenda.
Many subjects have been raised today and I am grateful to you, Madame Deputy Speaker, and to Members for giving me time to respond to them. As I suspect she would like me to do, I will give a couple of minutes to the hon. Member who opened the debate.
As I have already said, the workforce is key to our strategy. We have already committed to investing in and expanding our diagnostic workforce to improve survival rates by diagnosing cancer earlier. The first ever cancer workforce plan, which Health Education England published in December, set out how we will expand our workforce, how we will continue to invest in the skills of the staff we have, and how we will use their time and expertise where it is most needed.
HEE has already committed to training 746 more cancer consultants and 1,890 more diagnostic and therapeutic radiographers, which we know are in short supply, by 2021. The plan further commits to the expansion of capacity and skills, including 200 additional clinical endoscopists and 300 reporting radiographers by 2021.  HEE will also expand the number of clinical nurse specialists, as the shadow Minister rightly mentioned, and develop common and consistent CNS competences, with a clear route into training, to ensure that every cancer patient has access to a CNS or other support worker by 2021—that subject was constantly raised when I chaired the all-party group. HEE will follow the plan later this year with a longer-term strategy looking at the workforce needs beyond 2021.
The hon. Member for East Kilbride and others, including the hon. Member for Easington (Grahame Morris), talked about the link between the 62-day standard and the performance and phasing in of transformation funding. Cancer alliances, as the House knows, are an important mechanism for improving performance on the 62-day standard from urgent referral through to treatment. They bring together clinicians from primary and secondary care, as is right—one NHS. They ensure collective responsibility for the cancer services they provide, and they provide the necessary leadership for the transformation of services. So £76 million of funding has already been allocated to the cancer alliances.
It is imperative that the alliances have the operational rigour and readiness to achieve the transformation that we need. After all, our constituents’ money is being allocated. So it is only right and proper, as the Secretary of State made clear in the question and answer session at Britain against Cancer, that the alliances demonstrate their preparedness for this funding. That is not to say that the 62-day standard is a requirement, but it does give a basis on which NHS England and NHS Improvement, along with other senior clinical advisers, can assess an alliance’s readiness to transform services. Transforming services is what we want to do.

Grahame Morris: What happens when cancer alliances do not achieve the 62-day target? It seems completely perverse that individuals suffering from cancer in those areas are penalised by lack of funds from the transformation fund. Is the Minister saying that those cancer alliances can still apply for that funding and measures will be put in place to ensure that they do reach that target?

Steve Brine: Yes, this is not hard and fast. I noted that NHS England has written to me as a constituency MP and to all other MPs today with details of the cancer alliances that they have in their individual areas. I bang on about this every time, as the shadow Minister knows, but I implore Members to engage with their local cancer alliances. I suspect that the people in this debate do that, but I would hazard a guess that many other Members do not. Members should know who the cancer alliances are in their areas and should have a relationship with them.
Let me now discuss CPES, which the hon. Member for Strangford (Jim Shannon) mentioned, as did the hon. Member for Lincoln (Karen Lee). On her speech, let me just say, wow. I said to my officials before this debate that there is always one speech in these debates—the shadow Minister was that person a few weeks ago—who leaves not a dry eye in the House, and today it was the hon. Member for Lincoln. I know she is not in her place now and I do not blame her for that. I think the whole House wanted to run over to give her a hug—many Labour Members did, and bless them for doing that. I think that the House, in its own way, gave her a collective hug, and I say well done to her for an amazing speech.
We totally recognise how important CPES is in our continued drive to improve cancer treatment and care, and to monitor that progress. I have always been clear that I want any future survey to continue to deliver the high-quality data that CPES does. I can tell the House that CPES will continue in its current form in 2018-19. We will engage with the cancer community to ensure that any decisions about future delivery and the model to be adopted, should the commissioning arrangements be revised, are informed by all parties and ultimately protect the integrity of the survey and quality of the data. I saw Dame Fiona Caldicott last week in Oxford and discussed the subject with her. Obviously, her work as the patient data guardian led to the challenge we now have—it was necessary work, but it certainly left us with a challenge. Cally Palmer, the national cancer director, and I will meet all the major cancer charities next week at my second roundtable, and this is on the agenda and we will be discussing it with them. I hope Members know that CPES remains very much at the top of my agenda.
Let me touch on early diagnosis, because everybody else has and because it is one of the most important shows in town. In every conversation I have ever had about how we can beat cancer, I have been told, “Early diagnosis”. Historically, our cancer survival rates have lagged behind the best-performing countries in Europe and around the world. The primary reason for that is, without question, late diagnosis. Sir Harpal Kumar will stand down as chief executive officer at Cancer Research UK shortly, but I had the privilege of having lunch with him a few weeks ago, when I asked him what we should think about in terms of the next cancer strategy. He said, “The rock upon which you build your church is early diagnosis.” I will not forget that, which is why one of the key priorities of the strategy is to diagnose cancer earlier, when the disease is more treatable.
How are we doing that? As part of our drive to ensure early diagnosis, we are also introducing the new 28-day faster diagnostic standard from GP referral to diagnosis or the all-clear. I have often said, and I repeat now, that 28 days is not a target; it is a maximum. I well know that when people have a cancer worry, 28 minutes seems like a lifetime, let alone 28 days. However, the 28-day standard is really important. It will be introduced from April 2020. Five pilot sites have started testing the new clinical pathways to ensure that patients find out within 28 days whether they have cancer or the all-clear.
Today, Public Health England, for which I have ministerial responsibility, has launched its 14th “Be Clear on Cancer” campaign, which focuses on breast cancer in women aged over 70, something that my hon. Friend the Member for North Warwickshire (Craig Tracey)—my excellent successor chair of the all-party group on breast cancer—mentioned. That campaign will run until the end of March. It focuses on age-related risk, encouraging older women to be breast aware, and particularly to be aware of non-lump symptoms, which, understandably, have lower levels of awareness.
The other point I want to make on early diagnosis is that we know that the hardest cancers to detect are those where early symptoms can be vague and often symptomatic of less serious illnesses. Patients often see their GP multiple times before that all-important referral. That is why we are piloting 10 multidisciplinary diagnostic centres as part of wave 2 of what we call the ACE—  accelerate, co-ordinate and evaluate—programme. Patients presenting to their GP with vague symptoms can be referred to an ACE centre for multiple tests, one after the other, and receive a diagnosis or the all-clear on the same day. The initial findings are incredibly exciting; I do not get easily excited, but I am excited about this. I had the pleasure of visiting one of the ACE pilots at the Churchill Hospital in Oxford last Tuesday, during recess, and I have to say that the enthusiasm and feedback I got from clinicians and patients about the potential of the ACE centres were really quite incredible. I look forward to seeing the analysis on that work in the coming months.
The shadow Minister talked about emergency room presentations, which are something I was quite shocked by as a Back Bencher when I went to all-party group meetings. It is true that emergency room presentations for cancer are horrible, but that is why the 28-day standard and the ACE centres are so important. When I talk to GPs, they tell me that they will refer and that there will then be a wait. Patients who are, understandably, worried and terrified may then present themselves at an A&E, at which point they may be diagnosed with a primary cancer. That then hits the stats around emergency room presentations for cancer. It does not mean that those people have been carried in; they have often walked in. That all explains why we need to grip early diagnosis better than ever.
My hon. Friend the Member for Bosworth (David Tredinnick) talked about Baroness Jowell’s speech in the other place last month. The Secretary of State was there to listen to the speech, and it was incredibly powerful. Baroness Jowell met the Secretary of State and the Prime Minister this morning. Investment in brain cancer research has been limited by a pretty low volume of research proposals focused on the topic in recent years, and we have been working with charities, academics and the pharmaceutical industry to address that over the last 12 months.
To accelerate our efforts in brain tumour research, the Secretary of State has today announced, alongside Cancer Research UK and Brain Tumour Research, a package to boost research and investment into this most harrowing form of cancer. We have announced £20 million through the National Institute for Health Research over the next five years, with the aim of doubling this amount once new high-quality research proposals become available. CRUK has confirmed it will provide £25 million of its money over five years in major research centres and programmes dedicated to brain tumours. Today’s announcement is incredibly positive.

Rachael Maskell: I have listened patiently and, unfortunately, I was not here at the beginning. However, my constituent has a very rare form of cancer. He has had to self-fund his treatment in Germany and Southampton, but he has run out of money. The treatment meant he did not die within the weeks he was given and is now living. However, he needs top-up therapy, and his individual funding request has been refused. Without his treatment, he will not live. Could the Minister look into this case?

Steve Brine: Obviously, I will not comment on the case. I was going to suggest that the hon. Lady gets the clinicians to make an IFR, but she can by all means bring the case to me.
My hon. Friend the Member for North Warwickshire talked about breast density. The UK National Screening Committee commissioned a Warwick University study to investigate the link between breast density and breast cancer. Once complete, if the review suggests that there should be changes to the national breast screening programme, the UK National Screening Committee, which we work with, will consider that under its modification programme. I am in touch with Breast Density Matters, which is a small charity—small but perfectly formed.
The hon. Member for Coventry North East and others talked about blood cancer. We had a very good Westminster Hall debate last month led by my hon. Friend the Member for Crawley (Henry Smith). As has been said, many patients with blood cancer diagnosis will sadly never be cured; they will be on the regime of watch and wait, often over many years, to see whether the cancer has progressed to a point where treatment needs to begin. That can take a huge psychological toll, which Members have mentioned, on the patient and their families.
By 2020, every patient will receive a holistic needs assessment as part of the recovery package, which is excellent. For the blood cancer patient, their recovery plan will be personalised to take account of the unique characteristics of blood cancer, and will include their mental health needs. That is why the Secretary of State announced the additional £1.3 billion last July to expand the mental health workforce. My hon. Friend the Member for Dumfries and Galloway (Mr Jack) made that point very well in his speech—I say this as I am passed a note. I love the notes from the Whips.

David Tredinnick: Will the Minister give way?

Steve Brine: No, I will not, because I want to finish.
My hon. Friend the Member for Dumfries and Galloway touched on the cancer dashboard, including, yes, rarer cancers. NHS England and Public Health England are currently considering next steps on how we can expand the dashboard. They know that I am frustrated about its being limited to the top four, and I want to see us expand it and do better, and they have had a very clear direction from me on that.
The hon. Member for Bristol West (Thangam Debbonaire), as always, spoke brilliantly. What a brilliant advertisement for her all-party group and its inquiry. If there is anything that I can do to help—I do not know about the cost of cancer report, but if she sends it to me, I would love to see it—she knows that she only needs to ask.
The hon. Members for Scunthorpe and for Easington talked about pancreatic cancer. NHS services for pancreatic cancer have significantly improved in recent years, with clearer diagnostic pathways, decision making by specialist multi-disciplinary teams and the centralisation of pancreatic surgery with specialised teams. On 7 February, the National Institute for Health and Care Excellence published the final guidance on the diagnosis and management of pancreatic cancer in adults. This will ensure quicker, I think, and more accurate diagnosis referred to specialist MDTs, and better access to psychological support. The hon. Member for Scunthorpe mentioned tumour profiling tests. NICE has made a decision on that. I will get it to write to me with an explanation of that decision, as he has asked, and I will share that with him.
Let me conclude by paying tribute to the staff who do so much, the patient groups and the charities that are working so hard as part of team cancer—we are all on the same team when it comes to cancer—to implement the cancer strategy and to save lives. We are on track to deliver, we think, but we need to make more progress, especially on early diagnosis and looking further forward on the subject of prevention, as I have said. I thank all Members for speaking today. The fight goes on.

Lisa Cameron: Today’s debate has been so profound and amazing, with so many personal contributions. I have been absolutely astounded by the breadth and depth of knowledge across the House and the absolute dedication to the cancer strategy right across these Benches. I am assured that we will work together, taking things forward very positively and making a difference.
It is important that we have discussed the fact that cancer cuts across the lifespan and recognise the serious issues for young people and their experience of cancer. We also looked at not just the physical aspects, but the mental health aspects and the support that is required. We talked about the fact that treatment has to be holistic and evidence based.
I wish to commend the valuable contributions from charities and our NHS staff. To be honest, their support is invaluable because they are on the frontline. I also wish to mention the very personal contribution of the hon. Member for Lincoln (Karen Lee). She made such an amazing speech today. I am sure that, given her experience, she will go on to support and assist so many people, and I am delighted that she is a cancer ambassador. I am sure that many people will benefit from that in the future. Once again, I thank her and everybody here today, and I look forward to working with them on this issue.
Question put and agreed to.
Resolved,
That this House has considered the cancer strategy.

City of London Corporation: Pensions

Motion made, and Question proposed, That this House do now adjourn.—(Wendy Morton.)

Kate Hoey: I would rather not be here this evening speaking in this Adjournment debate, not because I do not care about the issue very much, and particularly about my constituent, Mr Clifford Bell, but because I believe that it is such a simple matter that it should have been resolved years ago. It has not been, and I gave a commitment to my constituent that I would bring it to the House in an Adjournment debate.
I want to begin by setting out the facts of my constituent’s case before moving on to the problems that I have faced in seeking to resolve it, and the relevant basic policy concerned. My constituent, Mr Clifford Bell, worked for the City of London Corporation as a security and services assistant from December 1989 until he suffered an injury on 6 November 2000. He slipped on a metal screw while walking down some marble stairs, fell, hitting his head, and was knocked unconscious. Mr Bell’s health deteriorated while he was on subsequent ill-health leave, as he went on to suffer from loss of hearing in his right ear, incessantly loud tinnitus, dizziness, loss of balance, and a series of blackouts that occurred without warning, four of which led to his hospitalisation.
On 10 December 2001, the City of London Corporation made a claim on his behalf to the Department of Work and Pensions to pay him industrial injury benefits, and he was then assessed by a DWP doctor. In February 2002, he was notified that he had been diagnosed with
“loss of mental equilibrium and loss of neurological function”,
and awarded industrial injury benefits for 12 months before a further examination. He continued to be awarded annual industrial injury benefits until 8 December 2008, when he was adjudged to be qualified to receive industrial injury benefits for life.
On 10 June 2002, Mr Bell met the City of London Corporation about his long-term absence from work and submitted a written application for an early retirement ill-health pension, but he was informed two days later that this was being turned down because the City of London Corporation’s in-house doctor could not say that Mr Bell’s injuries were permanent. He informed them that their two options of either early retirement on a basic pension or alternative work were not acceptable to him, and the City of London Corporation deemed him no longer to be an employee from 24 September 2002.
After months of resistance, Mr Bell was finally provided with a copy of an additional accident report that the City of London Corporation had sent to the Health and Safety Executive 17 months after his accident spelling out that it found
“it difficult to believe that he could have slipped on a screw whilst wearing Dr Martens safety shoes”
and that
“there are a number of staff…who suspect that the incident, if it really happened as Mr Bell describes it, may have been exaggerated.”
Not only do vague beliefs and suspicions have no place in an accident report, but I reiterate that he was diagnosed annually by the DWP for eight years before being awarded lifetime industrial injury benefits in 2008.
In June 2004, Mr Bell filed a grievance against the City of London Corporation for its handling of this case, and in 2005 he signed a compromise agreement for the City of London Corporation’s insurers, Chubb insurance Ltd, to consider his case under the Local Government (Discretionary Payments) Regulations 1996. The insurers found in his favour and awarded him a termination package of about £50,000, but not an ill-health pension.
That is the timeline so far of Mr Bell’s case. So far as he was aware, these were the relevant facts, until in 2012 he discovered the local government pensions committee’s circular 252, which noted that the Local Government Pension Scheme Regulations 1997 should have been relevant in his case. Regulation 97(9) states:
“Before making a decision as to whether a member may be entitled under regulation 27 or under regulation 31 on the grounds of ill-health, the Scheme employer must obtain”—
must obtain—
“a certificate from an independent registered medical practitioner as to whether in his opinion the member is permanently incapable of discharging efficiently the duties of the relevant local government employment because of ill-health or infirmity of mind or body.”
Regulation 98 sets out that he should have received a written notification of the decision by the IRMP as soon as possible, giving the reasons for the decision and setting out his appeal rights to the Secretary of State under regulation 102.
The Local Government Pension Scheme (Amendment No. 2) Regulations 2001 further specified, in sub-paragraph 9A:
“The independent registered medical practitioner must be in a position to certify, and must include in his certification a statement, that—
(a) he has not previously advised, or given an opinion on, or otherwise been involved in the particular case for which the certificate has been requested; and
(b) he is not acting, and has not at any time acted, as the representative of the member, the Scheme employer or any other party in relation to the same case.”
None of those regulations—not one—was followed.
In Mr Bell’s research at that time, he discovered two relevant appeals, 869 and S00495, which saw the Secretary of State emphasise the importance of the opinion of the independent registered medical practitioner, including one judgment against the City of London in 2008. By the time Mr Bell discovered that those requirements had not been followed, he was well out of time for consideration by the pensions ombudsman.
Mr Bell first contacted me in September 2014, and I wrote my first of many letters to the City of London Corporation seeking to understand why the rules had not been followed in his case. I wrote to the City of London on 20 October 2014, 26 May 2015, 6 July 2015, 12 October 2015 and 4 November 2015, on each time to the head of the human resources department who had dealt with his case. On each occasion they responded by stating that Mr Bell was not eligible for an ill health pension, making reference to the Local Government Pensions Committee’s circular 252 in 2011 and the details of the compromise agreement he had signed in ignorance of his actual rights. Despite my repeatedly asking why the 1997 and 2001 regulations had not been followed in his case, those questions were not answered.
On 27 January 2016 I wrote to the town clerk and chief executive of the City of London, quoting regulation 97(9) of the 1997 regulations and simply asking why those  and the similar 2001 regulations should not apply in this case. In his answer of 26 February, the town clerk, John Barradell, stated:
“In May 2002 the Corporation’s Occupational Health Team advised that there was ‘no evidence of permanent incapacity due to ill health so medical retirement is not an option at this point’. This view was confirmed on 11th June 2002 when Dr Copeman”—
the corporation’s internal doctor—
“advised that he was unable to state that Mr Bell had any form of medical condition or illness which would result in his permanent inability to work for the Corporation in his current position. This medical opinion meant that it was not possible under the LGPS for Mr Bell to be retired on the grounds of ill health.
It appears that Mr Bell has misunderstood the application of Rule 97(9) referred to in your letter. Rule 97 was not engaged and there was no requirement for an IRMP because Dr Copeman’s advice was that Mr Bell did not come within the requirements for ill health retirement.”
I admit that I became very frustrated at that point. The suggestion was that because the internal doctor did not give approval, the independent doctor need not be asked for their opinion, which strikes me as the whole point of the protections set out in those regulations.
In seeking to make sense of that, I wrote to the then Minister for Local Government, the hon. Member for Nuneaton (Mr Jones), in July 2016, setting out the case and stating that Mr Barradell’s answer was
“as clear as mud, since the rule clearly states that independent analysis must be obtained before such a decision is made.”
I asked him to confirm first that the legal position remained as I stated in the letter, secondly whether there would be any exemption to the requirement that independent analysis be obtained before a decision would be taken on an individual’s eligibility, and thirdly what recourse Mr Bell could follow to get what he is entitled to. As expected, the Minister did not—quite rightly—go into detail about my constituent’s individual case, but he confirmed that the regulations were in effect at the time and did not indicate any scope for exemptions.
I wrote again to Mr Barradell on 12 December 2016, asking him to review his decision based on the confirmation given by the then Minister. He did not reply to this letter, and so I had to chase him—not literally—and he eventually replied on 30 May 2017, stating that
“the City’s position as set out in previous correspondence…remains unchanged”,
and that it did not believe it had had any obligation to inform Mr Bell of his rights at the time. He concluded:
“The City Corporation remains of the view that it has acted properly and fairly in its handling of this case and believes there are no grounds for it to consider this matter further.”
Mr Bell has tried to pursue this down many avenues over the many years since the original injury in 2000, but because he did not discover the details of the 1997 LGPS regulations until 2012, he had by that point already exhausted his appeal options. I had stated to the City of London Corporation on several occasions that if it could not satisfactorily explain why the rules should not apply in this case, I would have to raise this matter in the House. That is why I believe I have no option but to do so now.
There are two alternatives: either the City of London is refusing to apply the rules properly, or the regulations as they exist do not work as they should to provide the assurance of an independent assessment. Industrial injuries  are by their nature unexpected, disturbing and painful events. If they are of the severity to lead to an ill-health retirement, it is quite right that this should follow assessment by an independent doctor as soon as possible, and that it should follow a process that sets out the details clearly. Surely such a process cannot and should not be short-circuited by the decision of an organisation—particularly an organisation such as the City of London Corporation—to use an in-house doctor, and not allow the worker to have their injuries certified by an independent practitioner.
I apologise to the Minister and to the House for this very detailed tale, but I wanted to put it on the record. Fundamentally, is the Minister happy with the way in which these regulations operate? Is he aware of other cases where organisations have used the decision of an in-house doctor to override the need, as laid down by the regulations, to get the opinion of an IRMP? If he is aware of such cases, does he intend to tighten the process to prevent this from happening? Is he also concerned about organisations—particularly an organisation such as the City of London Corporation—not giving workers details of their rights in such instances? Is he aware of other complaints about the City of London Corporation in particular not fulfilling its obligations under these regulations? It has not been forthcoming with details to me. Possibly most difficult, can he recommend any further steps that my constituent Mr Bell can follow to have his case finally considered by an independent medical professional? He is even willing to pay for that independent medical professional in order to get an opportunity to have his case looked at.
For over 17 years, Mr Bell and his family have relentlessly pursued what seems to me to be a grave injustice. In my view, the fact that that grave injustice has been perpetrated by one of the richest local authorities in the country makes it even more disgraceful. I hope that the Minister will be able to provide me with some assurance for me to give my constituent that this will change, and that he will get justice.

Rishi Sunak: I congratulate the hon. Member for Vauxhall (Kate Hoey) on securing this debate. I had the pleasure of fighting alongside her in the referendum campaign, and I can see that she has for many years applied the same tireless and tenacious campaigning instincts to this case on behalf of her constituent, and I commend her for those efforts. I particularly welcome the chance to respond to the points that she has made and, indeed, I share her regret that we have had to debate this on the Floor of the House.
Pensions are not just about regulations and procedures; they are about security and peace of mind. We all want to retire on a decent income, and as we live longer and healthier lives, we want to be able to save more and make the most of our retirement. Public sector schemes such as the local government pension scheme include insurance-style benefits that help to cushion us against the most unfortunate events. There are protections when staff are made redundant, and provision for their dependants if they die in service, as well as ill-health benefits such as those at issue in this debate.
Throughout the past 100 years, the LGPS developed as a national scheme to become a valuable and integral part of local government, valued by millions. That said, as the recently ensconced Minister responsible for local government pensions, I can attest that it is not a simple scheme. Some of that complexity comes from the need to cover a wide range of possible scenarios. The provisions dealing with injuries at work—such as those suffered by Mr Bell—will interact with statutory schemes of compensation, employers’ sickness procedures, and employment law. Injuries can lead to periods of sickness and to permanent or temporary incapacity. Justice comes from treating like cases alike, but also from making fine judgments and distinctions between cases where appropriate. I want the best possible administration of the scheme. It has been a key aim of the Government to improve transparency and accountability in decision making by public bodies such as this.
The LGPS is a national scheme set out in regulations, but it is important to note that it is administered locally. That has been a long standing feature of the scheme, and often one of its strengths. As the hon. Lady will know, local authorities are independent bodies and, first and foremost, they are accountable to their electorates through the ballot box, rather than to central Government. That said, there are routes for independent redress where local authorities fail in their obligations—for example, through the council’s complaints procedure, the Local Government Ombudsman or, when appropriate, the Pensions Ombudsman. Potentially, and finally, the case can be considered by the courts by judicial review.
It is a feature of any legal system of redress that administrative deadlines and statutes of limitation are associated with each of those, and I am sure the hon. Lady will recognise that all sides in a dispute often benefit from the certainty and closure that those afford. I also believe, however, that if local authorities are to retain the trust of the people they serve, they should always seek to act honourably and correct mistakes, even if they are under no legal obligation to do so. Where I feel a need to call out mistakes, I will do so, from the Dispatch Box if necessary. I hope that my voice in these matters will not be without some moral force.
It gives me comfort that in general the LGPS is well-administered, and the vast majority of complaints received about it are resolved internally. It pays out £9.5 billion in benefits each year, and despite that I am told that there were fewer than 91 complaints to the Pensions Ombudsman, and of those, fewer than 15% were upheld. Clearly some mistakes will be made, and the impact of those mistakes could be hugely significant for vulnerable people or those of limited means who rely on their pension to sustain their dignity and standard of living in old age.
Let me turn to the details of Mr Bell’s case. The hon. Lady forcefully made her case that the City of London has not complied with its statutory obligations or delivered justice to Mr Bell. As she would expect, my officials have been in touch with the City of London to hear their explanation of events.
It is worth stressing at the outset the obvious difficulty of understanding in precise detail events that happened almost 20 years ago. However, from hearing both sides it strikes me as common ground that as a consequence of the accident on 6 November 2000, Mr Bell suffered  some degree of incapacity. The question appears to be about the degree of severity and the permanence of that incapacity. I expect it is difficult for any medical expert to give a very definite answer to those questions. It is for that very reason that I would expect this to be settled as a question of fact by someone that both parties can have confidence in. That is the plain meaning and intent of regulation 97.
I can see no good reason why the City of London Corporation chose not to instruct an independent registered medical practitioner who could have either confirmed or corrected the judgment that was reached, no doubt in good faith, by the corporation’s occupational health team. Not only was an IRMP not instructed, other consequences followed the failure to consider that a decision of any kind was due in respect of Mr Bell’s application for ill-health retirement. The protections and regulations 98 to 102, whereby a member is informed of his rights of appeal and a reference to the Pensions Advisory Service, appear also not to have kicked in as one might reasonably have expected.
Of course, I cannot say what conclusions the IRMP would have reached, or whether indeed an appeal would have been successful. What I can say is that Mr Bell does seem to have suffered an injustice by being denied an independent assessment of this case. However, I must note that Mr Bell did receive legal advice from a reputable firm of lawyers in settling the terms of his dismissal, for limited efficiency, in 2002. In coming to a decision on how best to pursue his case and whether to accept those terms of settlement, I would hope that the advice he received was complete and accurate.
Let me now address directly the questions the hon. Lady put to me in her closing. First, I am very happy to place on record my concern that the regulations do not seem to have been followed in this case. My clear view is that on the facts available to me at this time an IRMP ought to have been engaged in 2002. If the hon. Lady believes it may serve some purpose, I would be very happy to write formally to the corporation and ask it to justify this omission to me.
On the hon. Lady’s other questions more generally, I personally am not aware and the Department is not aware of any other such cases where this practice was followed, nor of any other specific complaints about the corporation’s administration practices. I would hope that if there were cases similar to Mr Bell’s, they would have found their way, correctly and appropriately, to the pensions ombudsman. There, I believe, the arguments advanced would have received a strong hearing.
The hon. Lady asked if I wish to tighten the rules in this area. Having reviewed it, to my mind the regulations then, as now, are clear about the process to be followed. The regulations then, as now, place the correct emphasis on the need for decisions to be taken in a timely way, based on independent advice and with further avenues for advice or appeal clearly signposted. Having reflected on it, the issue at stake here is not that the regulations themselves were at fault, but whether they were properly adhered to and followed. If they were not, however, then at this point, sadly, I cannot see any specific further steps I can take to pursue this case on behalf of the hon. Lady and Mr Bell.
If we were having this conversation at the time of the incident in question, Mr Bell would have had the avenue of appeal and redress through the council’s own two-stage  appeal process. Following that, we could have gone to the pensions ombudsman, the Secretary of State or the courts through judicial review. As I said earlier, however, there are good and necessary reasons why we have time limits and limitations in the determination of rights and liabilities. Statutes of limitation are common across civil and criminal law in this country and across the world. Parties must be allowed to know when a matter has finally been settled. Given where we are now, 18 years after the incident in question, unfortunately the ability to access any of those avenues has obviously expired.
At the time, Mr Bell did receive legal advice and sought a settlement with his employers. I very much hope that his solicitors at the time discussed with him these various avenues that may well still have been available at that time and provided advice to him on the best course of action. It may well be worth Mr Bell or the hon. Lady discussing the matter again with the solicitors to make sure that all the correct procedures and avenues were explored. Owing to the separation of powers between central and local government, I cannot intervene in the day-to-day activities of local authorities, except where specific provision is made by Parliament, and I am not aware of any specific basis on which I could intervene directly in this case.

Kate Hoey: I thank the Minister for giving way—I know he is coming to the end of his speech—and for his thoughtful response. Does he accept that it should have been up to the City of London Corporation, a council hugely rich in personnel, to inform Mr Bell of his rights? It should not have been up to a solicitor a few years later. Surely there was a moral duty if not a legal duty—I think there is a legal duty; I think the regulations give a legal duty—to inform him of his rights and to allow that independent medical practitioner. That was where it all went wrong—something so, so simple. Does he agree that there is a moral case in respect of the City of London Corporation? I should add also that I would welcome his writing to it on my and Mr Bell’s behalf.

Rishi Sunak: Not only is there a moral duty; but—the hon. Lady is right—there is a legal duty both to have used an independent medical practitioner and to have informed Mr Bell of his rights at the time. Mr Bell would, I hope, have been aware of those rights through many of the other communications he would have received as a member of the scheme, but at the point when it became relevant, under articles and provisions 98 to 102, he should have been made aware of them again. It will be of limited comfort to Mr Bell and the hon. Lady, but the pension scheme’s statutory advisory board is currently reviewing the means of resolving disputes locally and looking at simplifying the rules around ill-health retirement. I expect recommendations from the board in due course, and obviously this matter will weigh on my mind as I review those recommendations.
In conclusion, though we have discussed process, I do not want to lose sight of the individual at the centre of this, Mr Bell. The accident that caused him to lose his job seems such a small and random piece of bad luck. That we are still talking about it today shows how unfairness of any kind—of fate or in administration—can be very hard to accept and live with. I do not know whether he is adequately supported today and leading a   fulfilling and satisfying life, but I sincerely hope that he is. I commend the hon. Lady again for her tireless work in advocating so forcefully on behalf of her constituent. I know that she will keep pushing the City of London Corporation to examine afresh whether it acted fairly  and in good conscience, and I will support her in those efforts. I wish her and Mr Bell every success as she pursues this case.
Question put and agreed to.
House adjourned.